Key takeaways for government agencies:
- Awareness is growing, but many Medicaid beneficiaries still don’t know what the new requirements mean for them.
- One in four respondents are unsure whether they’ll need to report qualifying activities, creating a significant communication challenge for agencies.
- Beneficiaries want practical support, including clear checklists, deadline reminders, self-service tools, and access to real time, human assistance.
- Successful implementation should prioritize reducing confusion and helping eligible individuals maintain coverage while minimizing administrative burden.
Community engagement requirements are quickly moving from policy discussion to operational reality for state Medicaid agencies. While much of the conversation has focused on implementation timelines and compliance, another question deserves just as much attention: Are Medicaid beneficiaries prepared for what’s coming?
To better understand that question, CITIZ3N surveyed 408 current Medicaid beneficiaries living in Medicaid expansion states that will be subject to the new community engagement requirements. We wanted to understand not only what people know about the upcoming changes, but whether they understand how those changes apply to them and what actions they’ll need to take.
The findings suggest that awareness is growing, but readiness is far less certain. Many beneficiaries remain unclear about whether they’ll need to report qualifying activities, what documentation may be required, and where to turn for guidance. That uncertainty has important implications for state agencies as they prepare new verification, reporting, outreach, and member support processes. Below are 4 takeaways from the survey that I believe agencies should consider as they prepare for implementation.
Medicaid Work Requirement Awareness Is Growing, But Readiness Remains Low
At first glance, the survey results appear encouraging. Nearly two-thirds (66.7%) of respondents said they had heard at least something about the upcoming Medicaid community engagement requirements.
However, only 38.5% of respondents said they had heard “a lot” about the new requirements, while 28.2% had heard only a little. One-third (33.3%) had not heard about them at all.
Awareness is an important first step, but it doesn’t necessarily mean beneficiaries understand how the requirements apply to them or what they will need to do to maintain coverage.
It’s also important to view these findings in context. As of June 2026, most states have not yet launched broad beneficiary outreach related to community engagement requirements, and communication timelines will vary based on each state’s implementation approach and federal review process. Many agencies are still building the operational processes, systems, and communications needed to support implementation.
Even so, the survey suggests there may be value in starting member education early. Agencies will need to help beneficiaries understand whether they are subject to the requirements, what qualifying activities count, when reporting is required, and where to go for assistance. Moving from general awareness to clear, actionable guidance may be one of the most important factors in minimizing unnecessary coverage disruptions.
Many Medicaid Members Still Don’t Know Whether the Requirements Apply to Them
When asked whether they believed they would need to report work, school, volunteering, caregiving, or another qualifying activity to maintain Medicaid coverage, more than one in four respondents (25.7%) said they weren’t sure. Meanwhile, 35.8% believed they would need to report, while 38.5% believed the requirements would not apply to them.
That uncertainty changes the nature of the challenge agencies are trying to solve. Many beneficiaries are still trying to determine whether they need to report at all.
Without clear eligibility guidance, confusion can quickly become an operational burden. Beneficiaries who aren’t sure whether they’re subject to the requirements are more likely to contact call centers, seek assistance from caseworkers, miss reporting deadlines, or fail to submit documentation they didn’t realize was required.
As states continue preparing for implementation, helping beneficiaries answer a simple question, “Do these requirements apply to me?”, is just as important as building the reporting process.
Medicaid Members Want Clear Guidance, Simple Tools, and Timely Reminders
When asked what would be most helpful if they were required to report qualifying activities, respondents prioritized practical, action-oriented resources over lengthy explanations.
More than half (54.2%) said they wanted a checklist outlining exactly what they needed to do. Another 41.2% wanted text or email reminders before important deadlines, while 34.1% wanted a website or app where they could check their status. Nearly one-third (31.4%) said access to a real person for support would be valuable.
The survey also highlights the importance of balancing digital convenience with human support. Many respondents expressed interest in self-service capabilities such as checking their status online or uploading documentation electronically, but they also want confidence that help is available.
Another notable finding was respondents’ interest in automatic verification using information the state already has. That aligns closely with CMS guidance encouraging states to rely on trusted data sources before requesting additional information from beneficiaries.
Implementation Success Should Be Measured by Coverage Continuity
Community engagement requirements are often discussed in terms of compliance, reporting, and program administration. The survey serves as a reminder that implementation also has a direct impact on healthcare access.
When asked what they would do if they lost Medicaid coverage, 35.0% of respondents said they would delay or skip doctor visits. Nearly one in three (28.2%) said they would delay or skip prescription medications, while 33.8% said they would go without health insurance altogether.
These findings underscore what’s at stake as states prepare for implementation.
Reducing friction points will be an important part of that effort. Clear communication, reliable eligibility verification, streamlined reporting, and proactive reminders can help prevent procedural disenrollments while reducing administrative burden for agencies.
Download the full survey for additional findings and learn how CITIZ3N Verify™ Engage helps state agencies streamline verification, reporting, member outreach, and compliance.
I’d be happy to continue the conversation. Connect with me on LinkedIn or reach out to learn more about how CITIZ3N is helping agencies prepare for community engagement requirements.
