The federal reconciliation bill signed into law this summer, otherwise known as the One Big Beautiful Bill or HR 1, requires that state Medicaid agencies make significant changes to eligibility determinations and processing for the Medicaid expansion population, otherwise known as Group VIII in the Affordable Care Act. These changes include, among others, eligibility determinations every 6 months and a work/community engagement requirement.
Interested parties are invited to submit information to improve the process
In preparation for these changes, the Ohio Department of Medicaid (ODM) issued a request for information or RFI. Earlier this month, they asked interested parties to submit information useful to inform these major changes. The RFI asks “How would your organization address verification compliance with the community engagement requirements or verify that an individual has met an exemption to those requirements?”
Although this is not a formal rulemaking, ODM is inviting responses from “interested parties.”
Advocacy organizations can and should use this opportunity to document concerns about how these systems could affect access to coverage.
This is the first step to determining Ohio’s work requirements
This RFI is important because it represents one of the first steps toward deciding Ohio’s version of Medicaid work requirements—determining how eligibility is verified, how exemptions are handled, and ultimately how many people keep or lose their health coverage.
Community Solutions encourages interested parties to respond to this RFI so that the state has a robust and diverse pool of information to inform what will be a complicated process of engaging over 170,000 Medicaid expansion enrollees whose work/community engagement or potential exemption from the requirement cannot be currently verified through other systems.
Feedback will help determine how eligibility is verified, how exemptions are handled, and ultimately how many people keep or lose their health coverage.
Responses are due to the state no later than 4pm on October 29.
