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"How Medicaid Payers can Prepare for New Work Requirements Coming in Early 2027"

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Under the Reconciliation Act of 2025, adults under 65 who don’t qualify for exemptions must verify they meet new work requirements. The new requirements, which go into effect in January 2027, pose new challenges for payers and states to reach these Medicaid members, who must show they have completed at least 80 hours of work, education, or volunteer activities each month or risk losing their coverage.  

Payers already struggle to connect with this population and now must bridge communication divides. GroundGame.Health and HMA urge payers to communicate clearly and early, automate form submissions, and share data. Healthcare and tech also must collaborate in new ways following best practices like designing compassionate, comprehensive and compliant solutions and using culturally appropriate communication.

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