Resources and Toolkits

Tools for data-driven understanding Medicaid work requirements, including information about who’s at risk, automatic verification pathways, ex parte capability by state, coverage loss, and maps

Analysis and dataset providing an overview of how states are using budgets and legislation to respond to H.R. 1.

Living spreadsheet that tracks major E&E and MMIS vendors by state.

An analysis projecting Medicaid expansion disenrollments on the national, state, and subgroup level beginning in 2027, estimating between 4.9 million and 10.1 million adults could lose coverage by 2028 due to administrative barriers and reporting requirements.

Interactive tracker to evaluate how prepared states are to implement the Medicaid administrative changes required under H.R. 1, using performance indicators like application processing, call center performance, and disenrollment data. The tool highlights potential risks states may face in maintaining access amid implementation.

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.

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.

A CMS-developed suite of open-source tools that streamlines income and community engagement reporting for Medicaid applicants and enrollees

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 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.

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.

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.

Guide explaining automatic benefit notice generation process while walking through common underlying system errors (e.g. missing or incorrect information) providing insight on how back-end design decisions cause these issues. Provides strategies to improve notice process and output such as targeted questions on system logic, workarounds for caseworkers, and structural reform through data flow, boilerplate language,…

Guide to provide states with policy and technical strategies to reduce procedural terminations under Medicaid work requirements, including simplifying verification processes, mitigating automation risks, managing vendor

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.

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.

Features interviews from seven states on adaptation journeys in response to SNAP and Medicaid on integrated eligibility and enrollment. Insights include states awaiting federal guidance, standing up work groups, putting technology road map placeholders, prioritizing SNAP PER, making changes to end-of-life systems, rethinking data sharing, and considering population impacts.

Explainer on state IEE system fundamentals, outlining key technologies, opportunities, risks, and stakeholders involved for implementation guidance to improve benefit accessibility and efficiency.

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

A central resource library for state, local, tribal, and territorial governments working to implement public benefits policy and system changes created through OBBBA, featuring Medicaid work requirements and SNAP PER topic sections.