Across the United States from Massachusetts to Illinois to California, state legislators are hammering out the details of their state’s specific approach to comply with the Medicaid work requirements laid out in the Trump Administration’s One Big Beautiful Bill Act (OBBBA). While the OBBBA creates the requirement for able bodied adults to participate in 80 hours a month of volunteer work, education, job training, or employment, there are many important considerations for states to consider. Chief among these considerations is how do states accurately track data for each individual Medicaid recipient to ensure that they are meeting the requirements or are added or removed from the system as their circumstances change.
In this week’s round up we look at how states are preparing for the Medicaid work requirements with the 2027 deadline looming.
States Unprepared for New Medicare Work Requirements
A recent article published by Healthcare Dive explores how most states are ill-prepared to meet the 2027 deadline. According to researchers from Georgetown University, while states have just months to establish systems of record and other complex administrative requirements, they realistically need several years to accomplish this work. The report warned that “[w]ithout swift improvements in administrative readiness, [the new requirements] will deepen state challenges, increase costs, and leave millions of children and families at risk of losing health coverage.”
Interested in learning more, you can read the full article here.
Georgia Offers Guidance for the Rest of the Country
While state governments are under pressure to develop their plans to track Medicaid qualifying activities, the State of Georgia has been up and running with their Pathways to Coverage program since 2023. While the program has certainly been critiqued for its complexity and the inevitable errors that occur in tracking data, it is the only available example for other states and there’s a lot to be learned from their experiment according to Cynthia Perkins, Director of Solutions for Health and Human Services at TCS – Tata Consultancy Services.
“There is a considerable amount of data that needs to be tracked in order to comply with the work eligibility requirements under the OBBBA,” she explained. “Not only are there multiple activities to track and ensure they add up to 80 hours on the back end, but a person’s eligibility status may change quickly.” For example, pregnancy changes eligibility requirements as does leaving the workforce to become a full-time caregiver. If those changes aren’t tracked, Medicaid recipients can lose benefits at critical life moments.
To help states on their journey to compliance with the OBBBA, Perkins provides some useful insights on how taking advantage of AI and investing in data readiness can help states build a successful program. Ready to get started on building a successful Medicaid work eligibility solution to meet the 2027 deadline. You can find all you need to know here.
California Looks to New Digital Identity Tools to Ease Eligibility and Tracking Requirements
For the state of California, the Medicaid work requirements bring a unique set of challenges with the largest population of recipients to track, and a complex web of state and local government agencies involved in the process. However, early investments in digital identity use may help Californians report their data and maintain eligibility.
In a report published earlier this year by State Scoop, Kelly Quinlan examined how California’s Chief Technology Officer, John Porat, is looking to expand digital identity verification technology across platforms. From mobile drivers licenses to real-time discount bus fare eligibility verification, there are already several use cases in play. What is driving success for California, is that they’re tackling the issue of data interoperability and building an infrastructure that’s adept at moving data seamlessly and quickly between organizations, which is crucial to a program like Medicaid work requirement and eligibility tracking.
“[We’ve] seen a lot of states come out with mobile versions of their driver’s license, and we’re proud as a state to have that as well, but we’re really thinking about, how can we digitize the way that we validate residents identities and eligibility for different programs,” he said. “So, we’re working with a bunch of different state departments to pilot out how that would actually work out in practice. We’ve been spending the last year or so building out the infrastructure, and we’re proud to now actually get started on some pilots that Californians are actually using.”
You can read the full article here.