WASHINGTON — States have begun Medicaid enrollment screenings and eligibility reviews as part of a new federal mandate aimed at increasing the frequency of verifications for certain beneficiaries, officials said.
The requirement, stemming from provisions in the 2025 reconciliation law known as the One Big Beautiful Bill Act, directs states to conduct eligibility redeterminations at least every six months for adults enrolled through the Affordable Care Act's Medicaid expansion. Implementation of the more frequent reviews is scheduled for January 2027, with preparatory screenings and outreach activities underway in 2026.
The Centers for Medicare and Medicaid Services issued guidance in March 2026 on the changes, which affect expansion populations in participating states. States are required to perform more regular checks on income, residency and other eligibility factors, building on the resumption of routine redeterminations after the end of pandemic-era continuous coverage.
This mandate is part of broader adjustments to Medicaid eligibility processes. Additional elements include work or community engagement requirements set to take effect in 2027 for certain adults, along with other modifications to enrollment rules. Some states have initiated early actions, such as data matching and notices to enrollees, to prepare for the shift.
Officials from the Department of Health and Human Services have described the screenings as necessary for program integrity and ensuring benefits go to eligible individuals. "States must verify compliance... before requesting additional information," according to federal summaries of the verification process.
Advocacy groups and some state officials have raised concerns about the potential for coverage disruptions, particularly for beneficiaries with fluctuating incomes or those facing barriers to responding to notices. They note that more frequent reviews could increase administrative burdens on state agencies and lead to higher rates of procedural disenrollments.
The changes apply primarily to expansion adults, while other Medicaid populations continue under existing annual review cycles unless otherwise specified. Details on exact implementation timelines vary by state, with some beginning targeted outreach in mid-2026.
As of June 17, 2026, many states are in the process of updating systems, conducting data cross-checks and sending notifications to affected enrollees. Full enforcement of the six-month cycle is slated for early 2027, with ongoing monitoring by federal authorities. No comprehensive national enrollment impact figures from the new screenings have been released.
