Navigating Work Requirements with AI-Driven Eligibility and Enrollment Solutions Under H.R. 1
The One Big Beautiful Bill Act (H.R. 1 or OBBBA) was signed into law on July 4, 20251, introducing significant changes to Medicaid policies and operations.
New Medicaid work requirements, along with related provisions in H.R. 1 such as 6-month eligibility redeterminations, the elimination of Supplemental Nutrition Assistance Program (SNAP) work requirement waivers, and reduced SNAP administrative funding, are set to significantly increase technical and administrative pressures on state eligibility systems. Without a clear strategy, states risk higher costs, compliance challenges, and disruptions in effectively serving stakeholders.
The Challenge for States
States must adopt clear and efficient strategies to update eligibility and enrollment systems and avoid costly and time-consuming delays. Integrating AI solutions into existing eligibility and enrollment systems can help streamline processes and maximize efficiency.
How A&M Can Help: P.A.T.H. Framework for Adopting AI Solutions
The A&M P.A.T.H. (Plan, Adapt, Transform, Harmonize) Framework provides states with a flexible, end-to-end approach for implementing AI within complex systems like Medicaid. Covering everything from planning to long-term sustainability, it emphasizes cost-benefit analyses, integration with existing systems, and iterative testing. Beyond the framework itself, A&M offers governance, technical support, and structured methods to help states avoid common risks, accelerate implementation, and achieve sustainable modernization and measurable improvements in their Medicaid programs.
Although the PATH framework is tailored to each state’s unique environment and needs, implementing under tight timelines can introduce risks and challenges. A&M is ready to rapidly mobilize, guiding states through this complex journey to maximize technology within existing Medicaid ecosystems. Explore how A&M helps states modernize Medicaid eligibility and enrollment operations.
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Look out for more content from A&M on integrating AI solutions into state eligibility systems.
1 - U.S. Congress. H.R.1 - 119th Congress (2025-2026): One Big Beautiful Bill Act. Congress.gov. Accessed August 27, 2025. https://www.congress.gov/crs-product/R48569.
