Comparing Medicaid and Supplemental Nutrition Assistance Program Work Reporting Requirements Exemptions
H.R.1 provides for certain mandatory exemptions from Medicaid work reporting requirements, including for some people enrolled in the Supplemental Nutrition Assistance Program (SNAP). As states implement Medicaid work reporting requirements, this tool can be used to identify where exemptions from Medicaid’s new work reporting requirements may overlap or relate to exemptions in SNAP to help states identify people who should not be subject to work reporting requirements in Medicaid.
CMS Releases Rural Health Transformation Funding Opportunity
On September 15, the Centers for Medicare & Medicaid Services released a Notice of Funding Opportunity (NOFO) for states to apply for funds under the $50 billion Rural Health Transformation Program, established by H.R.1. This analysis summarizes the NOFO including the allowable uses of funding, application components, and the distribution and scoring methodology.
Mandatory Medicaid Work Reporting: Implementation Requirements and Decision Points
While H.R.1’s mandatory work reporting requirements are prescriptive, states must still make a number of policy and operational decisions that will heavily influence whether eligible individuals are able to enroll in and retain coverage. This toolkit details the federal requirements for various features of the mandatory work reporting requirements, outlines state policy and operational options, and provides key considerations related to maximizing efficiencies and mitigating coverage losses.
Medicaid Work Reporting Requirements: Verifying Compliance and Exemptions
H.R.1’s mandatory work reporting requirements expressly direct states to use an ex parte process, relying on reliable information to verify compliance and mandatory exemptions, and avoiding requests for additional information from individuals whenever possible. To meet the aggressive timeline required by federal law to implement mandatory work reporting requirements, states can use this toolkit to support their assessment of which data sources are currently available and which data sources require new state builds and/or data matching processes.
Open Enrollment 2025 Communications Toolkit
As the open enrollment period for plan year 2026 approaches, health insurance Marketplaces face a rapidly shifting policy environment. These changes will influence the way Marketplaces engage with enrollees, community partners, and stakeholders. This toolkit is designed to help State-Based Marketplaces maintain trust with enrollees and stakeholders; communicate clearly and effectively; prepare enrollees for upcoming changes; and help enrollees maintain coverage and access care. The toolkit includes content that states can customize to reflect their voice and policy context.
Medicaid Work Reporting Requirements: Implementation Planning Milestones
H.R.1, signed into law by President Trump on July 4, 2025, requires that states implement work reporting requirements for adults ages 19 through 64 who are enrolled through Medicaid expansion or expansion-like coverage under a section 1115 demonstration. The effective date of work reporting requirements is January 1, 2027 and states will need to proactively prepare for implementation by developing comprehensive policy and operational plans that align with federal guidelines while addressing state-specific needs. The toolkit outlines the key implementation milestones that it is anticipated states will need to meet to launch work reporting requirements and a timeline for doing so.
Budget Reconciliation Implementation Roadmap
This Excel tool provides an integrated view of implementation dates for Medicaid, the Children’s Health Insurance Program, Marketplace, and Medicare provisions in the budget reconciliation law, H.R.1. Because of interdependencies with the budget reconciliation provisions, policies in the Marketplace Integrity and Affordability final rule of June 25, 2025, are also included in this timeline. This tool is intended to support states in (1) planning for timely implementation of reconciliation-driven health policy changes, and (2) effectively communicating potential impacts to communities and key stakeholders.
Changes to Medicaid in the Budget Reconciliation Law
On Thursday, July 24, State Health and Value Strategies hosted a webinar on the budget reconciliation legislation (H.R.1) and the sweeping changes to Medicaid that it will make to state Medicaid program expenditures, enrollment, and operations now (with many provisions having already taken effect upon enactment) and in the years to come. It concentrates cuts to the Affordable Care Act’s Medicaid expansion population, limits use of provider taxes and state directed payments, constraining the ways states can raise revenue to finance their share of Medicaid program costs, and adds major restrictions on access to affordable health coverage for noncitizens.
Changes to the Marketplaces: Implementing New Regulatory and Legislative Requirements
On Thursday, July 10, State Health and Value Strategies hosted a webinar for State-Based Marketplace and Division of Insurance officials. On July 4, the president signed the reconciliation budget bill into law, starting the clock on a number of changes to Marketplace coverage and premium tax credit eligibility. Just two weeks earlier, the Centers for Medicare & Medicaid Services finalized its Program Integrity rule that also creates new requirements for Marketplaces. During the webinar, SHVS’ experts discussed the immediate changes that states are facing and what steps to take in the coming days and weeks.
Senate-Passed H.R. 1: Updated Estimates on Impact to State Medicaid Coverage and Expenditures, Hospital Expenditures, Including Impacts by Congressional District
On July 1, the Senate passed Republicans’ budget reconciliation bill, H.R.1. Using its Medicaid Financing model, Manatt Health has prepared updated estimates on the Senate-passed bill, including state-by-state estimates of Medicaid coverage and expenditure impacts, hospital expenditure impacts, and new Congressional District-level coverage and hospital expenditure impacts.