HR1, formally titled the One Big Beautiful Bill Act, introduces sweeping changes to eligibility and enrollment for Medicaid and the Supplemental Nutrition Assistance Program (SNAP). These policy updates bring major financial and administrative changes for government agencies and call for a strategic and innovative approach to implementation.
In this blog, we outline six actionable strategies to help agencies stay compliant while continuing to deliver quality services to eligible communities.
With key implementation deadlines beginning December 31, 2026, agencies must act decisively to avoid delays. It will require trusted technology partners capable of agile development with a track record of meeting tight deadlines and implementation experience in adapting to changing policy and guidance.
Strategic modernization efforts initiated now can prevent the need for costly retrofitting of legacy systems later. Proven platforms ready to support these changes enable agencies to move quickly without starting from scratch.
Example in action: Social Security Scotland has earned multiple awards for its benefits system, and is a good example of the value of flexible systems when policy and implementation occur simultaneously due to aggressive timelines. Their integration of three separate benefits into a unified program required close collaboration between IT and policy teams. The solution supported both a flexible and agile implementation approach to meet the evolving technology and policy requirements within the program’s operational deadline.
HR1 calls for a fundamental transformation of agency operations, with community engagement emerging as one of the most significant areas of change. Agencies will need to redesign workflows to support the tracking and verification of work requirements, including identifying individuals who are exempt. This shift will require the introduction of new evidence types and verification processes that impact both application processing and renewal procedures. Additionally, agencies will be expected to launch targeted outreach campaigns to ensure compliance and engagement across their communities.
Agencies with modern platforms are better positioned to respond swiftly to these demands. Configurable workflow engines and rules-based systems offer the flexibility to adapt to evolving requirements and integrate automation without the need for full system overhauls. This adaptability becomes critical when navigating policy changes that introduce multiple decision points and conditional logic throughout eligibility determination processes. For agencies currently undergoing major modernization initiatives, it’s worth exploring how these initiatives can be leveraged to reduce the change required on legacy systems.
Lessons learned: Recent state experiences with work requirement implementation highlight the importance of eligibility systems with flexibility and adaptability. In certain states, technical hurdles created barriers to enrollment, with applicants facing complex verification requirements that overwhelmed an already understaffed department. Platforms failed to provide the agility needed to respond to policy changes, leading to significant investments in solutions that struggled to meet the needs of both caseworkers and citizens. These challenges underscore the necessity of realistic workflow design, adequate staff capacity, and systems automation that incorporates digital sources. By prioritizing system flexibility and simplifying processes, agencies can better serve customers efficiently, reduce errors, and improve experiences for both workers and citizens, ensuring that families are not left facing unnecessary hardships while waiting for essential benefits.
Effective outreach will be key to reducing churn and loss of coverage for eligible individuals. Early communications not only keeps enrollees informed but also builds trust and reduces confusion during periods of significant change.
Agencies should begin planning comprehensive messaging strategies now, tailored to different populations, communities, and communication channels, including social media. Outreach should clearly explain what's changing, what actions individuals will need to take, and when. Incorporating automated communications, such as SMS reminders, emails, and AI-powered chatbots, can all help maintain consistent engagement and reduce the risk of eligible individuals becoming unenrolled.
Agencies planning for HR1 can also draw on lessons learned from CMS State Unwinding Best Practices1 to help inform their outreach strategies. An example of successful outreach during Unwinding can be seen in Tennessee.
Case study: TennCare’s digital outreach success
Tennessee’s Medicaid program, TennCare, implemented targeted digital advertising campaigns using Facebook, Instagram, and Google Search to reach specific populations during the unwinding period. These efforts led to a 107% increase in renewal responses, a 29% increase in website traffic, and the creation of 16,000 new online accounts in just three months.1 This example highlights the power of data-driven, multi-channel outreach in improving engagement and reducing coverage gaps.
Effective implementation of community engagement requirements and more frequent eligibility checks will require agencies to identify relevant data sources and establish comprehensive data-sharing agreements. Integration not only streamlines community engagement processes but also supports the identification of individuals who may be exempt from community engagement requirements.
Agencies should prioritize mapping data sources that support both verification and exemption determinations. Electronic verification may serve most cases, but agencies must develop alternative workflows for situations requiring manual documentation, including volunteer work, gig employment, and self-employed individuals.
Leveraging integration and automation will be key to reducing manual effort and improving accuracy across the eligibility process.
Example in action: States like South Carolina, that are implementing work requirements under a waiver,2 are moving forward with data integration strategies and data sharing agreements, showing how proactive planning can enable automation and reduce administrative burden.
More frequent eligibility checks combined with new community engagement requirements, may significantly increase the administrative complexity and workload for caseworkers – raising the risk of errors. To mitigate this, agencies should incorporate automation into new workflows to enable no-touch or low-touch processing for applications and renewals.
Leveraging automation and AI in verification workflows can help minimize manual input, reduce errors, and improve data accuracy across all eligibility processes. Where integration is not available, agencies should explore AI tools to support eligibility verification that can be used across a range of verification documents, including IDs and pay stubs for example, to reduce manual tasks and support low-touch processing.
Outreach campaigns are also essential to ensure enrollees understand new requirements and deadlines. Automated communications can keep beneficiaries informed and engaged, helping prevent coverage loss and delays caused by missed steps in the process.
With the increased demands on both individuals and caseworkers as the result of HR1, self-service portals and automated workflows are essential tools for reducing manual effort and supporting caseworkers with higher volume workloads. The streamlined, digital-first approach of self-service portals also empowers citizens by giving them greater control and access to manage their own cases more efficiently, improving the citizen experience.
By combining document upload capabilities with AI functionality, agencies can extract and validate data automatically, reducing the need for manual review and accelerating verification timelines. Faster verifications mean quicker processing, which helps prevent coverage loss due to manual delays.
AI powered assistants can also play a critical role in guiding citizens through the changes introduced by HR1. These tools can help individuals understand new eligibility requirements, identify what documentation may be required and answer common questions, reducing confusion and improving engagement without placing increased burden on the agency.
HR1 brings complexity and aggressive implementation timelines that demand agility, accuracy and efficiency from government agencies. The new requirements, verification mandates, and administrative processes require an agile implementation plan supported by reliable technology partnerships and a flexible health and human services (HHS) platform.
Medicaid directors face mounting pressure from ongoing policy changes, budget constraints, and workforce challenges. The choice of technology platforms and implementation partners becomes paramount for successfully navigating this complex terrain while maintaining service quality and accessibility for eligible populations who depend on these essential safety net programs.
While no single solution will fully address the complexities of HR1, agencies can rely on proven strategies and technologies to navigate the transition successfully. With the right combination of modern platform, automation and expert services, it’s possible to meet the evolving policy demands.
Cúram is uniquely positioned to help agencies meet the challenges of the evolving policy and increasing operational demands. Cúram’s purpose-built platform offers the flexibility to configure and extend solutions that align with evolving policy requirements without the need for costly system overhauls. The platform's proven adaptability and functionality are designed to reduce administrative burden on caseworkers, addressing the critical issues of workforce retention and preventing burnout in an already strained system.
Beyond technology, the Cúram services team brings extensive experience in large scale transformation projects. With a strong track record of deploying integrated eligibility systems during legislative transitions, Cúram can help agencies meet implementation deadlines.