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HCA details work requirements and six‑month renewals for ~600,000 expansion adults
Summary
HCA told senators HR 1 will require community engagement (work) for the Medicaid expansion adult population (about 600,000 people) starting Jan. 1, 2027, explained exemptions, an $580/month income threshold (80 hours equivalent), a verification hub for automated checks, and limits on self‑attestation after 2028.
Trinity Wilson, Medicaid and CHIP director at the Health Care Authority, told the Senate committee that HR 1 introduces a community engagement requirement for adults covered by the Medicaid expansion (about 600,000 people) effective Jan. 1, 2027.
Wilson described the eligibility tests: an average monthly income of at least $580 (equivalent to 80 hours per month at the federal minimum wage) would satisfy the test; otherwise, enrollee activity such as half‑time education, 80 hours of work, or 80 hours of community service in a month would meet the requirement. She also listed exemptions — including people under 19, foster youth, pregnant and postpartum people, parents/caretakers of young children or people with disabilities, tribal members, those incarcerated or within 90 days post release, SNAP/TANF households, Medicare enrollees, medically frail individuals, and short‑term hardship categories.
On redeterminations, Wilson said the expansion adult group will move from 12‑month certifications to 6‑month recertifications effective Jan. 1, doubling the frequency of renewals for that population. She estimated that roughly one‑third of the expansion caseload already meet work requirements by income, another third will qualify for exemptions based on existing data, and roughly one‑third (about 200,000 people) lack sufficient information and may need to attest or provide documentation.
To operationalize the rules, HCA is building a back‑end verification hub it said will connect to ProviderOne (complete), the National Student Clearinghouse, Veterans Affairs and later to Employment Security and DSHS for wages and SNAP/TANF data. Wilson cautioned that CMS’s interim final rule reduces reliance on self‑attestation beginning in 2028, increasing documentation burdens for some enrollees and providers.
Wilson said HCA will follow CMS’s required notice schedule: at least two notices (one at least four months prior to implementation and one at renewal), and described a multimodal outreach plan (mail, email, text, robocalls, paid ads) and a community connector forum to support outreach.
The committee did not vote; members asked for additional detail on automation rates and outreach.
