Operationalizing New H.R.1 Medicaid Copay Requirements: A Toolkit for States

Manatt Health

Beginning October 1, 2028, H.R.1 requires states to impose co-payments for services provided to Medicaid expansion adults with income above 100% of the federal poverty level. This toolkit is intended to support states in understanding and implementing H.R.1’s new copay requirements for certain Medicaid expansion enrollees that meet specific income requirements. The toolkit provides an overview of the new copay requirements and proposes an operational approach to ensure compliance with federal requirements and reduce states’ administrative burden and potential barriers for members.

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