Reshaping Medicaid: Considerations for Monitoring the Impact of H.R.1

Elizabeth Lukanen and Emily Zylla, SHADAC

H.R.1 makes sweeping changes across the Medicaid program, including major shifts in enrollment, eligibility, expenditures, and operations. To understand these impacts, it is imperative that state officials develop a monitoring strategy. This issue brief outlines the strategic case for investment in monitoring, provides a phased action timeline for states to implement monitoring activities, and details potential priority monitoring domains. By pairing real-time early warning data with long-term outcome analysis, states can link observed trends, such as coverage loss, directly to specific policy drivers. Ultimately, a robust and standardized monitoring strategy creates the necessary record to understand the true fiscal and human costs of these changes as they unfold.

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