Policy & Practice | Spring 2026

ou don’t need a crystal ball to predict where state Medicaid agencies are headed. New federal regula tions under H.R. 1—including community engagement requirements, semiannual redeterminations, and T OF MEDICAID HE FUTURE The Future of Medicaid Advancing Eligibility Through a Marketplace Model Y enhanced verification standards—ensure that the years ahead will be demanding. Agencies already managing growing case loads, constrained budgets, workforce shortages, and rising service expectations must determine how to integrate these changes while continuing to meet the needs of approximately 70 million people 1 nationwide who rely on Medicaid for health care coverage. With the January 2027 deadline looming, it’s understandable that states are searching for the quickest route to compliance. But some forward-looking leaders are using this moment to consider deeper questions as well. What if these mandates were approached not just as a compliance challenge, but as a catalyst for service excellence? What if H.R. 1 ushered in a faster, simpler, more dignified Medicaid experience that works as well for staff as it does for the people they serve? By Sean Toole

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