Resources and Toolkits
These 5 Million People Are About to Lose Their Medicaid — But They Don’t Have To
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
Projected Reductions in Medicaid Expansion Enrollment Under OBBBA’s Work Requirements and Six-Month Redeterminations
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.
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.
Eligibility Made Easy (Emmy)
A CMS-developed suite of open-source tools that streamlines income and community engagement reporting for Medicaid applicants and enrollees
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.
OBBBA Resources for States
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.
Metrics That Matter For States Under H.R. 1
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.
Implementing Medicaid Work Requirements
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.
Human-Centered Principles for States Evaluating Vendor Solutions to Implement H.R.1 Work Reporting Requirements
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.
A Technical Guide for States to Reduce Procedural Terminations from Medicaid’s Work Requirements
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
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.
Work Requirements Implementation Resources Toolkit
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.
Implementing Benefits Eligibility + Enrollment Systems: State Responses to H.R. 1
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.
Digital Government Hub for H.R. 1 Implementation
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.