The Power of Transparency: How States Can Use Data Dashboards to Effectively Monitor H.R. 1

May, 22, 2026

The Power of Transparency: How States Can Use Data Dashboards to Effectively Monitor H.R. 1

Elizabeth Lukanen and Emily Zylla, SHADAC

H.R. 1 will bring wide-reaching changes to the Medicaid program, including new work reporting requirements, more frequent renewals, eligibility changes for lawfully present non-citizens, and changes to how states can finance their Medicaid programs. As these provisions take effect, states will face questions from policymakers, advocates, researchers, and the media about how these changes are impacting both the Medicaid program and the individuals who rely on it for coverage.

One effective and proven approach to meeting this challenge is creating and publicly publishing a Medicaid enrollment and retention data dashboard. Drawing on lessons learned during the COVID-19 Public Health Emergency (PHE) and the subsequent Medicaid unwinding of the PHE continuous coverage requirement, this expert perspective outlines the case for state H.R. 1 data dashboards, provides practical design guidance, and highlights successful examples of recent state dashboards.

The Case for Real-Time Monitoring

To date, the Centers for Medicare & Medicaid Services (CMS) has not publicly released any reporting or monitoring requirements for H.R. 1, and it remains unclear if or when such federal guidance will be issued. In the absence of a federal reporting framework, and given the likely surge in demand for reliable information, accurate and timely state‑level data becomes even more essential. States that invest in monitoring infrastructure now will be far better positioned to meet that demand when it arises.

A well‑designed H.R. 1 dashboard can serve several distinct purposes:

Detecting early warning signs. Tracking near-real-time outcomes allows states to identify unexpected patterns, such as high rates of procedural denials or coverage losses among populations that appear likely to be eligible and intervene before coverage losses grow.

Monitoring disproportionate impacts. H.R. 1 will not affect all populations equally. Data disaggregated by eligibility group, age, race and ethnicity, language, and geography will help states understand which communities are experiencing disproportionate impacts and allow them to redirect resources, such as navigator or enrollment assister capacity, to where they are most needed.

Building trust through transparency. States should expect sustained information demands from advocates, legislators, researchers, and the press. A regularly updated, public-facing dashboard signals a commitment to administrative accountability and fiscal stewardship while offering a single, credible source of truth. Equally important, it allows states to share their own narrative alongside the data—clarifying what the data does and does not show, and distinguishing impacts of federal policy from impacts of state implementation choices, for example.

Best Practices for Designing an Effective H.R. 1 Data Dashboard

During the Medicaid unwinding, SHADAC tracked the development of state data dashboards and identified several practices that distinguished the most effective data dashboard examples from simple data repositories. Drawing on these lessons, the following guidelines provide a framework for presenting H.R. 1 data.

Engage community partners and Medicaid enrollees throughout the dashboard design and implementation process. As states design their dashboards, seeking early and ongoing input from a broad range of stakeholders will help ensure that the metrics selected are meaningful, the insights are accessible to diverse audiences, and that the final product reflects the information needs of those most affected by policy changes. For example, states could consider engaging: Beneficiary Advisory Councils and Medicaid Advisory Committees; community-based organizations that support or serve individuals with Medicaid; advocacy organizations; and managed care organizations. States could solicit this feedback directly from members through surveys, focus groups, or listening sessions. We also recommend including an email or comment box on the dashboard itself as a way for users to ask questions about the data or make recommendations, as demonstrated by Oregon’s medical redeterminations dashboard, which helped communicate state progress during unwinding.

Leverage existing infrastructure and data. Grounding your initial dashboard design in data you already have is a practical way to kickstart the engagement process. Because the timeliness of this data is so important, we recommend initially starting with a dashboard that draws on data that states already collect and report, such as metrics submitted to CMS as part of existing performance indicators and reporting requirements. States may also consider leveraging existing unwinding data infrastructure and reporting processes where possible.

Focus on the metrics that matter most for understanding H.R. 1 impacts broadly. Because the scope of potential monitoring is broad, we recommend thinking about indicators in phases, while also considering targeted indicators for populations and policy changes expected to be most directly affected, such as Medicaid expansion adults subject to work reporting requirements and six-month renewals. States can start with what is most immediately trackable and build upon existing data infrastructure, adding complexity over time as state capacity allows. A few starting indicators to broadly track H.R. 1 impacts might include:

Total enrollment and renewal trends: Month-over-month Medicaid enrollment figures and renewal outcomes.
Ex parte renewal rate: The share of renewals completed automatically without member action using existing data sources.
Disenrollment reasons: Total denials of enrollment or renewal broken down by procedural versus substantive causes, for example, “paperwork not returned” versus “found ineligible.”
Application and renewal processing times: Average and median time to process applications and renewals, including the share completed within federal timeliness standards.[1]
Coverage churn: The rate at which individuals lose coverage and reenroll within the reconsideration period (e.g., 90 days).
Coverage transitions: The number of disenrolled individuals who move to other forms of coverage, such as marketplace plans or employer-sponsored insurance.
Call center metrics: Call volume, wait times, language of caller, and call abandonment rates.
Fair hearings and appeals: The number of fair hearing requests filed, fair hearings pending beyond 90 days, successful appeals, and denials upheld.

Additionally, Georgetown’s Center for Children and Families has encouraged states to collect and report a core set of metrics specifically for monitoring Medicaid work requirements, which also can provide a starting point for states developing their indicator frameworks.

Prioritize data disaggregation. During the unwinding, many states’ dashboards provided data breakdowns by age, race and ethnicity, and program type to elucidate important trends on the disproportionate impact of coverage losses on economically or socially marginalized groups. Critically, this enabled states to respond in timely, and impactful, ways. Minnesota, for example, identified disparities in renewal outcomes by race and ethnicity early in the unwinding process and was ultimately able to eliminate disenrollment disparities for Black, American Indian, and Pacific Islander enrollees over the course of the unwinding period. At a minimum, we recommend that dashboards display data broken down by age, race and ethnicity, language, and geography.

Additionally, states should consider paying particular attention to specific populations that may face elevated barriers to meeting the new requirements of H.R. 1, particularly Medicaid expansion adults. States may also consider focusing on those who are pregnant or postpartum, individuals with chronic physical or behavioral health conditions, rural populations and populations with limited access to qualifying work activities or documentation infrastructure such as individuals experiencing homelessness or housing instability, those recently released from incarceration. Finally, states should consider documenting efforts to support individuals who have lost coverage, such as non-citizens.

Display pre-H.R. 1 baseline comparisons. Display current data alongside pre-implementation enrollment and renewal data so that users can readily see the magnitude of change over time and benchmark current performance against a stable reference point. For example, during unwinding, Massachusetts’ redeterminations dashboard displayed a clear indicator of baseline Medicaid enrollment prior to the PHE continuous coverage requirement that made it easy to see how the state was fairing during unwinding.

Contextualize the data. A key, and frequently underappreciated, function of a state dashboard is providing the context needed to interpret the numbers correctly. H.R. 1 will affect states differently depending on implementation timing, operational policy choices, and characteristics of their Medicaid populations. Without clear framing, data can be misinterpreted or misused. States should focus on making dashboards genuinely interpretable, not just data-complete. Effective approaches to clear data dashboard communication include:

Opening with a framing statement that describes the policy context, explains key data limitations, and orients users before they engage with the numbers. For example, the Massachusetts Health Connector’s Open Enrollment 2026 dashboard includes a standard “About This Enrollment Update” section at the top of the dashboard’s page, explaining the federal policy changes driving the data, and describing exactly what the dashboard does, and does not, track. During the Open Enrollment period, they also posted weekly key takeaways that provided narrative context around the numbers themselves.
Annotating visualizations with brief interpretive sentences placed directly next to trend lines, charts, and figures rather than in separate text, to highlight notable patterns and explain what may be driving them. Colorado’s Connect for Health marketplace dashboard includes visualizations accompanied by a short, italicized sentence that tells the reader what to notice and why.
Labeling all data clearly, including both counts and proportions. Providing counts and proportions allows users to understand both the absolute size and the relative composition of affected groups. Additionally, because rates can vary based on the denominator chosen (e.g., total enrollment vs. total due for renewal), states should select the metric that most clearly illustrates the state’s trends and explicitly define the denominator used. Monthly unwinding reports published by the New Hampshire Department of Health and Human Services (DHHS) display data both by individual counts and as a share of the total population due for renewal, as well as providing detailed definitions of population subgroups and terms.
Pairing the dashboard with a press release that synthesizes key findings in plain language for a general audience, combining framing, narrative summary, and state messaging in a single document—while also driving traffic back to the dashboard itself. Nevada used this approach during the unwinding, issuing a press release that explained the dashboard’s purpose, described what data would be tracked, and directed members and advocates to the dashboard and to Nevada Health Link for coverage assistance.

Use the dashboard to connect members and advocates to assistance. Include direct links to resources, such as pathways for members to update contact information, instructions for submitting required documentation, or outreach toolkits for advocates. Embedding links within the dashboard turns it from a passive data product into an active support tool. During the unwinding, Kentucky’s self-service, online coverage portal, called kynect, published an “unwinding page” on their website, combining enrollment data with a direct prompt for members to sign in and update their information, a locator tool to find a health insurance navigator (called a kynector in KY) or licensed insurance agent for in-person help, and a downloadable communications toolkit for community partners.

Looking Ahead

The changes H.R. 1 will bring to Medicaid are significant, and states will be operating in an environment of considerable policy complexity and public scrutiny. A well-designed, regularly updated data dashboard can give states a credible, transparent foundation for understanding what is happening in their programs, communicating effectively with community members, and distinguishing between the intended and unintended consequences of these federal changes.

SHADAC will continue to track state efforts to monitor H.R. 1 impacts and will maintain an updated resource aggregating state-specific data dashboard links as they become available. States that have published or plan to publish dashboards are encouraged to share that information with SHVS.

[1] Application processing: Eligibility determinations must not exceed 90 days for applicants based on disability and 45 days for all other applicants. Renewal processing: The CMS “Medicaid Program; Streamlining the Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment and Renewal Processes” final rule established new timeliness standards for renewals. Under the rule, states would be required to complete renewals by the end of the eligibility period, or the end of the month following the end of the eligibility period if all needed information was submitted less than 30 days prior to the end of the eligibility period. HR1 delayed implementation and enforcement of this provision, among others in the rule, under October 1, 2034.