Resources and Toolkits

This toolkit is intended to support states in understanding and implementing H.R.1’s new copay requirements for certain Medicaid expansion enrollees that meet specific income requirements. Included is a proposed operational approach to ensure compliance with federal requirements and reduce states’ administrative burden and potential barriers for members.

Issue brief outlining the strategic case for investment in monitoring, provides a phased action timeline for states to implement monitoring activities, and details potential priority monitoring domains.

Designed for state Medicaid and health and human services communications staff—particularly those responsible for planning and executing outreach related to new work reporting requirements. States can use it to inform the creation of communications efforts or to cross-reference existing plans, ensuring key tactics are considered, gaps are identified, and strategies are aligned around maintaining coverage…

A sequenced, implementation-ready approach for operationalizing the medical-frailty exemption.

Centralized hub for OBBBA Medicaid-related information for state implementation support. Features topics outlining communications and outreach, marketplace provisions, work requirements reporting, non-citizen eligibility changes, reporting and evaluation, rural health transformation, and state-specific impact estimates.

Guide on how state agencies can develop legible and flexible metrics to assess implementation of new work requirements, outlining how to build, capture, and effectively utilize metrics to monitor impact for operational awareness and decisionmaking.

Toolkit outlining federal statutory definitions for qualifying activities and mandatory exemptions, describing criteria for ex parte verifications, and assessing need for additional application questions.

Toolkit outlining key implementation milestones for states to launch work reporting requirements including creation of governance structure, shaping policy and operational design (e.g. defining state choice for “look back period”, qualifying compliance activities, etc.), preparing staff and systems readiness, partner engagement, enrollee education, and monitoring and oversight.

Implementation details on Medicaid work requirements outlining affected populations, exemptions, compliance pathways, information on state policy choices, and implementation timeline.

Implementation-oriented framework to support states with adapting to community engagement/work requirements. Features overview of “look back” period and four-step compliance flow including: checking for automatic hardship, screening for exemptions, checking for participation, and allowing for requestable hardship.

Outlines cases in which generative AI can be appropriately deployed by grounding use in human-centered problem statements. Highlights practical application such as data extraction, summarization, and entity resolution to reduce caseworker burden while maintaining responsible oversight.

Key questions for states to consider in human-centered vendor acquisition, focused on collaborative co-design and continuous feedback from enrollees and caseworkers during systems testing and development, proactive bias mitigation, accessibility, and strong data protection and interoperability standards.

Key questions for states to consider during procurement of new technical systems to ensure proper evaluation of product solutions and their effectiveness.

Repository of resources for state administrators to support the implementation of work requirement policies through overview of implications and recommendations of smart system designs and processes.

Outlines four proactive strategies to design resilient and adaptable technical systems including feature flags, modularity, configurability, and phased approaches.