H.R.
1,
known
as
the
One
Big
Beautiful
Bill
Act,
will
enact
significant
changes
to
Medicaid
in
January
2027,
including
work
requirements
for
certain
enrollees
to
maintain
eligibility.
It’s
estimated
that
millions
of
people
could
lose
coverage
due
to
these
work
requirements.
But
is
it
possible
that
there
will
be
a
slow
implementation
of
these
changes,
in
terms
of
removing
people
from
coverage?
One
healthcare
expert
believes
there
may
need
to
be.
“I
really
struggle
to
see
the
policy
being
launched
in
full
form,
in
full
effectiveness
on
January
1
in
an
enforceable
way,”
said
Matt
Salo,
founder
of
Salo
Health
Strategies.
“And
I
continue
to
believe
that
with
all
of
the
changes
that
need
to
happen
from
systems
and
government
decisions
and
plan
partnerships
and
member
outreach
and
engagement
and
activation
that
we’re
going
to
be
seeing
kind
of
like
a
soft
opening
of
a
restaurant
on
January
1.”
Salo
made
these
comments
during
a
Wednesday
panel
discussion
at
the
AHIP
Medicare,
Medicaid,
Duals
&
Commercial
Markets
Forum
in
Washington,
D.C.
He
added
that
if
there
isn’t
a
slow
rollout
of
the
changes,
it
may
look
bad
for
the
government.
He
said
negative
news
stories
are
likely
as
coverage
losses
occur
due
to
gaps
in
systems
and
insufficient
member
outreach.
“That
is
a
very,
very
bad
message,”
Salo
argued.
“And
I
don’t
think
there’s
a
state
in
this
country
who
wants
to
see
that,
and
I
don’t
think
the
administration
wants
to
see
that
either.”
Beyond
the
technical
hurdles,
Salo
warned
that
reaching
the
right
enrollees
with
the
right
information
will
be
a
challenge
for
states
and
health
plans.
He
pointed
to
the
unwinding
of
the
Covid-19
public
health
emergency,
when
states
ended
continuous
enrollment
provisions
that
had
allowed
beneficiaries
to
remain
covered
during
the
pandemic
without
undergoing
eligibility
redeterminations.
During
this
time,
states
just
had
to
deliver
one
message
to
all
enrollees:
get
redetermined
in
order
to
keep
coverage.
But
there
isn’t
a
single
message
to
deliver
to
all
Medicaid
recipients
when
it
comes
to
H.R.
1
changes.
“It’s
going
to
be
a
little
bit
different
this
time
around,
because
we’re
not
going
to
be
giving
the
same
message
to
everybody
in
the
Medicaid
program,”
Salo
said.
“There
are
some
people
we
don’t
want
to
communicate
to
necessarily
—
work
requirements
will
not
apply
to
them,
and
we
don’t
want
to
unnecessarily
confuse
them.
…
There
will
be
different
messages
for
the
different
populations
that
are
impacted.”
For
example,
work
requirements
generally
don’t
apply
to
pregnant
individuals
or
people
with
disabilities.
The
other
panelists
disagreed
that
there
will
be
a
slow
implementation
of
H.R.
1
Medicaid
changes.
Kate
McEvoy,
executive
director
of
the
National
Association
of
Medicaid
Directors,
noted
that
there
is
a
“Herculean
effort”
going
on
between
CMS
and
states
around
system
functionality.
For
example,
there
has
been
a
major
focus
on
improving
ex
parte
renewals,
which
verify
Medicaid
eligibility
using
existing
data
like
income
records
without
requiring
paperwork
from
patients.
“I
don’t
subscribe
to
Matt’s
version,
where
there’s
going
to
be
a
soft
rollout.
We
have
no
indication
from
the
administration
that
that
is
going
to
be
their
approach,”
McEvoy
said.
Another
panelist
echoed
McEvoy’s
comments.
“I
believe
we
will
have
made
much
more
progress
than
I
think
we
believe
is
possible
in
this
period,
[with]
some
of
the
new
technology,
some
of
the
new
outreach
methods
that
I
see,”
said
Darin
Gordon,
former
director
of
TennCare,
Tennessee’s
Medicaid
program.
“I
think
we’re
going
to
take
another
leap-forward
moment
here
where
we’re
going
to
actually
improve
our
overall
eligibility
process
significantly,
our
member
engagement
significantly.”
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