In September, states must start to notify Medicaid enrollees affected by new changes — including work requirements and new twice-yearly eligibility checks — that will begin in 2027.
These changes, introduced by the One Big Beautiful Bill Act of 2025 with a short implementation timetable, are expected to reduce Medicaid enrollment and potentially create confusion and chaos as beneficiaries try to understand whether and how new requirements affect them. States are required to notify people affected by the changing requirements using at least two outreach methods, but the exact methods are up to the state.
In what turned out to be good timing, we recently investigated what methods might be the most impactful, scalable, and low-cost. Our findings could help states determine cost-effective ways to connect Medicaid enrollees with assistance and prevent paperwork-related delays.
The process to confirm whether enrollees are still eligible, known as redetermination, has always been associated with red tape. Often, Medicaid enrollees lose coverage at the redetermination deadline not because they no longer qualify, but because of the difficulty in navigating renewal requirements.
This will only be exacerbated by the six-month redetermination rates and new work requirements introduced for many beneficiaries under the Trump administration’s tax and spending bill. As states roll out these new requirements, they will need strategies to ensure eligible people can maintain their Medicaid coverage.
