Last month’s 2026 State Healthcare IT Connect Summit in New Orleans made one thing clear: the primary hurdle for agencies adapting to H.R. 1 (the "One Big Beautiful Bill Act") isn't just understanding the policy—it’s the technical speed required to move from more static record-keeping to near-real-time engagement. While the implementation deadline for the new requirements is January 1, 2027, states must be ‘operationally ready’ by October 2026 to accommodate the required 60-90 day advance recipient outreach window. This article discusses the various issues and takeaways from the Summit to provide you with a summary recap including data verifications and beyond.
The Six-Month Redetermination Cycle: H.R. 1 requires eligibility checks every six months for the expansion population, effectively doubling the administrative workload.
The "Churn" Threat: If community engagement (CE) requirements require more manual intervention, the system risks added pressures of unintentional procedural disenrollments.
Implementation Funding: To help offset these transitions, H.R. 1 provided some initial support, including $200 million appropriated to states to states for FY 2026 to help with system updates, development and implementation.
The consensus among state leaders was that there is no more "steady state". Implementation is happening "in flight". Types of implementations can include:
Many states are aggressively pursuing a "no wrong door" approach where a single portal (e.g., MyLA or iServe) handles several programs' processes, e.g. Medicaid, SNAP, and TANF, simultaneously. This requires integrated leadership over just integrated tech.
The risk of retrofitting legacy systems, for example COBOL, with "digital duct tape" is high. Instead, leaders are favoring configurable middleware and modular "layering" of modern engagement tools over stable record systems.
Feedback from the summit confirmed that the "instant data first" model, utilizing instant data verifications services before engaging beneficiaries in consumer-permissioned verifications, resonated with leaders.
At the State HIT Summit, the message was clear: staying ahead of H.R. 1 changes requires more than just policy knowledge—it requires operational speed. To help your agency in advance of that critical December 31, 2026, deadline we’ve broken down the path forward into three practical pillars. These steps are designed to help you focus on ways to move past "digital duct tape" and toward a modern, automated system that actually works for both caseworkers and Medicaid members.
Finalize Implementation Roadmap: Solidify project plans now to ensure operational readiness and begin outreach to Medicaid members.
Implement "Exemptions First" Logic: Update systems to verify data points and exemptions (age, disability, frailty) before go-live dates to try and help prevent or reduce churn.
Define "Medically Frail" Data Process: Establish clear data sources for clinical ingestion to automate "medically frail" status verifications.
Anticipate June Guidance: Document working assumptions with CMS now to allow for rapid adjustments once final guidance is released in June.
Agentic AI Deployment: Launch autonomous AI for Tier 1 queries and document processing to potentially save up to 20–30 minutes of manual entry per case.
Adopt Modular Architecture: Layer modern engagement tools over legacy systems to increase agility and avoid "big bang" implementation risks.
Establish a Data "Golden Record" Baseline: Accelerate data normalization to create a longitudinal health record for more informed policy and risk-based decisions.
Invest in "Identity Intelligence": Move to persistent, risk-based monitoring to detect deepfakes and synthetic identity fraud across the platform.
Accelerate Procurement: Leverage existing contracts to bypass lengthy state cycles and rapidly purchase the use of, or access to, commercial off the shelf technology.
Establish "Tiger Teams": Co-locate clinical, policy, and IT teams daily to pressure-test system logic and ensure technical-policy alignment.
We are committed to helping your state navigate the complexities of H.R. 1 Community Engagement requirements to better plan and account for policy challenges prior to the new effective dates. To accelerate your progress and help you be ready by the December 31, 2026 deadline, we invite you to take these immediate next steps:
Schedule a Custom Strategy Session: Meet with us 1:1 to explore how these strategies and services can be utilized within your state's unique operational and policy landscape.
Prep An Implementation Timeline: Let us help you by offering practical recommendations for implementation steps ahead of the "Go-Live" deadline.
See Our Solutions in Action: Experience a live demo to see how we help verify community engagement hours with instant data.