One in Four Medicaid Members Lack Clear Next Steps Ahead of New Work Reporting Rules

CITIZ3N Government Solutions survey of over 400 Medicaid participants finds awareness is high, but many remain unclear on what the requirements mean for them or what actions are needed

STONY BROOK, N.Y., June 23, 2026 /PRNewswire/ -- As states prepare to implement new Medicaid community engagement requirements, a survey from CITIZ3N Government Solutions shows a clear gap between awareness and action readiness, with many Medicaid participants unsure whether the rules apply to them or what they will need to do next.

Quick Facts: Medicaid Community Engagement Requirements

• Medicaid community engagement requirements apply to certain adult Medicaid beneficiaries and require demonstration of qualifying activities as a condition of eligibility.
• States are responsible for verifying participation, administering reporting processes, and determining compliance and exemptions. Full program details are outlined by the Centers for Medicare & Medicaid Services (CMS).
• CITIZ3N Government Solutions surveyed 408 Medicaid participants; respondents most often said a clear checklist would help them understand what to do next.
• The findings point to a gap between policy awareness and clear, actionable guidance for Medicaid participants as states prepare for implementation.

CITIZ3N Government Solutions is a technology provider working with government agencies overseeing health benefits. The survey included 408 Medicaid participants in Medicaid expansion states subject to the new work requirements. Of those surveyed, 66.7% said they were at least somewhat aware of the new requirements, which go into effect on January 1, 2027. However, more than half (56.6%) said they had not received information from their state Medicaid program, and 25.7% were unsure whether they would need to report qualifying activities such as work, school, volunteering, or caregiving. Recipient outreach timelines will vary based on each state's implementation approach and compliance-review period, and states will need to deploy clear, multilingual, and multi-modal communications to Medicaid beneficiaries before community engagement requirements take effect.

"States are going to feel friction in turning policy into something operational," said Rob Miller, General Manager of CITIZ3N. "What looks straightforward in policy terms becomes more complex in practice, especially when you're coordinating across eligibility, reporting, outreach, and member support at scale. While this survey showed some level of awareness among Medicaid recipients, that is not the same thing as readiness to comply with the new guidelines."

Concerns Center on Coverage Loss and Access to Care
Uncertainty about potential rule changes is raising concerns about coverage. 68.1% of Medicaid participants say they would be very or somewhat concerned about losing Medicaid coverage if reporting requirements were introduced. If they lost coverage, respondents say they would most likely delay or skip doctor visits (35.0%), go without health insurance (33.8%), or attempt to find another coverage option (31.9%)

Members are Looking for Clearer Steps, Not More Information
When asked what would help most, respondents pointed to very practical needs. More than half (54.2%) want a clear checklist of what to do. Others pointed to text or email reminders before deadlines (41.2%), a website or app to check their status (34.1%), and a phone number to reach a real person (31.4%).

Communication Will Need to Meet People Where They Are
People are not relying on a single channel for Medicaid information. Email (63.0%) and text messages (58.8%) are most common, but mail (43.1%) and phone or in-person support (35.3%) still play an important role.

The findings point to the need for more coordinated, multi-channel communication as states prepare to implement new federal requirements.

"States are building out new processes that touch outreach, eligibility checks, reporting, and member support," said Miller. "That takes time to put in place, and most of it has to happen before the deadline. A lot of the challenge comes from working across multiple systems and data sources that don't always line up cleanly, which makes it harder to keep decisions consistent and clear at scale."

CITIZ3N Verify™ Engage supports state Medicaid agencies with tools to verify eligibility, manage reporting workflows, send notices, and track documentation. It also includes member-facing features such as status updates, reporting tools and document upload options.

To learn more about CITIZ3N Verify™ Engage and how it can help your state implement CMS community engagement requirements, visit www.CITIZ3N.com.

About CITIZ3N
CITIZ3N Government Solutions is a premier provider of integrated, modular platforms specifically tailored for government agencies overseeing Affordable Care Act (ACA) Marketplaces, Medicaid, Health & Human Services (HHS) and Government Health Benefits for Employees. The collaboration between CITIZ3N and Softheon epitomizes a shared vision of promoting innovative solutions that enhance affordability, accessibility, and efficiency, thereby fostering healthier citizens. For more information on CITIZ3N's solutions, visit www.CITIZ3N.com.

Media Contact
Allyson Van Wagnen
[email protected]

SOURCE CITIZ3N