Resources and Toolkits
How States Will Implement H.R. 1’s Medicaid Policies, Including Those Taking Coverage Away for Not Meeting Work Requirements
Analysis examining how states are likely to implement H.R. 1’s Medicaid provisions, including work requirements and other policies that can put eligible people at risk of losing coverage due to administrative barriers.The resource outlines key implementation timelines under both early and standard implementation scenarios, highlighting the first and last enrollee cohorts affected, major state policy…
States Need More Time to Prepare for Medicaid Work Requirement
States face an unrealistic timeline to implement Medicaid work requirements by January 2027 due to the compliance demands of data integration, system upgrades, and application portal modifications. These challenges are compounded by limited federal guidance, technical system constraints, and insufficient state capacity, making it difficult for states to adapt and administer the changes effectively. Consequently,…
Coordinating Medicaid and SNAP Work Requirements to Streamline Determinations
States can simplify and streamline determinations for individuals and agenciesand, reduce administrative burden, and minimize unnecessary coverage loss by leveraging the overlap in compliance activities and exemption reasons for individuals applying for or enrolled in both programs. Strategies on aligning exemptions, sharing data, and integrating verification processes highlighted through process flows and crosswalks.
Understanding CMS’s “Emmy” Medicaid Work Requirement Tools
CMS is offering states an open source, consent-based verification tool to streamline implementation of the Medicaid work requirement. This supports income verification for non-traditional workers, allows applicant review, and enables flexible system integration. Emmy API will also provide a single point of access for relevant data sources.
Data and Analytic Approaches for Medical Frailty Exemptions
Resource outlining data and analytic approaches to support states through the technology implementation and integration process for Medicaid work requirements, with a focus on medical frailty exemptions.
Assessing the Medicaid Work Requirement Vendor Landscape
Describes approaches states will take toward implementation, highlights considerations for evaluating vendors, and provides detailed descriptions of vendor products across categories (based on product demos and conversations with vendors)
Open Source Software Tool (OSCER) for Medicaid Work Requirements
Open-source community engagement reporting (OSCER) tool enables states to achieve work requirements compliance automatically using client and ex parte data, or otherwise provide link for manual certification or exemption application. Provides staff with case management and reporting tools, and sends results to state Medicaid agencies for issuance or disenrollment.
A Guide to Reducing Coverage Losses Through Effective Implementation of Medicaid’s New Work Requirement
Outlines strategies to reduce coverage losses including minimizing administrative and applicant burden, streamlining verification processes, creating accessible and user-friendly forms and portals, and strengthening communication and outreach efforts.