What Do We Know So Far About State Materials & Consumer Outreach on Medicaid Work Reporting Requirements?
By Adriana Kohler and Jade Little / May 7, 2026
States need to do effective, consumer-friendly outreach and education to communicate new work reporting requirements to affected Medicaid expansion adults and new applicants. Mandatory work reporting is one of the biggest seismic shifts in Medicaid policy in a generation, and without strong outreach and public awareness – including through content that is easy to understand – many individuals won’t know how to comply or if they are exempt, and will be incorrectly kicked off Medicaid coverage.
H.R. 1 requires states to reach out directly to people covered by Medicaid through regular mail plus one or more additional method, such as by phone, website, text, or other commonly available electronic means. Outreach must have information on how to meet work requirements (qualifying activities), an explanation of exemptions, consequences of non-compliance, and instructions for reporting compliance. States must also conduct outreach to impacted enrollees at least once every six months after implementation.
In most states, direct outreach to affected Medicaid expansion adults will occur between June and August 2026. At least two states – Nebraska and Montana – are implementing work reporting requirements early and have already mailed direct notices.
Nebraska sent this notice in December 2025 to adults enrolled in Medicaid expansion coverage.
Montana sent this universal communication in March to individuals in Medicaid.
Unfortunately, Montana sent its notice of upcoming changes to all individuals enrolled in Medicaid, not just Medicaid expansion adults, likely prompting many to worry whether or not they have Medicaid expansion coverage and are subject to the new rules, particularly low-income parents. Nebraska’s notice is written at a college reading level and does not indicate when coverage terminations will begin. Simply warning that, “starting May 1, 2026 you may be required to complete work requirements,” leads to confusion and requires people to jump through more unnecessary hoops. Neither notice includes critical details about parents – namely that parents with income below the state’s “Section 1931” mandatory income eligibility level are not subject to work reporting requirements regardless of the age of their children. Read more here about parents protected in the Section 1931 coverage group.
While direct outreach in most states will happen in the summer of 2026, many states are taking steps to educate consumers and other stakeholders. Let’s look at what we know so far.
29 states have a webpage or section on their state Medicaid website describing changes under HR 1, including Medicaid work reporting requirements.
4 states have posted presentation slides or stakeholder toolkits online, but may not have launched a webpage or website.
10 states do not, at this time, have a webpage or public materials about Medicaid work reporting requirements that impact their residents starting January 2027.
States are rushing to implement new mandates and be ready by H.R. 1’s deadline of January 2027 – and doing so without formal guidance from CMS on a range of critical issues. Given this, it’s not surprising that the extent of details on state webpages and the types of public-facing materials vary. A few states have printable/downloadable flyers, social media graphics, and one-pagers for consumers and those who work with adults in Medicaid expansion. Other state webpages offer high-level information, such as who is affected, qualifying activities, exemptions, and timelines. In some cases, information is combined with other H.R. 1 provisions, such as SNAP changes, the Rural Health Transformation Fund, or Medicaid eligibility affecting non-citizen immigrants. A few state webpages or resources that caught our eye:
Colorado has a detailed webpage for stakeholders about H.R. 1 changes, with links to webinars and extensive FAQs, separate from its enrollee-facing page, which is simpler.
Ohio has a landing page and Communications Partner Toolkit with sample flyers, rack card, and social media.
Louisiana has a comprehensive Communications Toolkit with sample flyers, and a sample notice to enrollees.
North Dakota’s webpage has simple consumer-focused messages, directs people to the self-service portal, followed by more detailed information.
State Health and Value Strategies also created a helpful resource to help states explain Medicaid work reporting requirements through clear, plain-language, and linguistically and culturally appropriate materials.