H.R.1 Medicaid Work Requirements · Member-Notice Window: Jun 30 – Aug 31, 2026

Eligible people are about to lose Medicaid over paperwork. We make sure they don't.

When H.R.1's work requirements take effect, most coverage loss won't come from non-compliance — it'll come from confusion: missed notices, language barriers, and unclaimed exemptions. The eligibility-system vendors are building the engines that decide who qualifies. We build the part they didn't — plain-language, multilingual member communications, exemption education, and an "Am I exempt?" member assistant.

◆ CMS-compliant, deadline-fast ◆ English & Spanish, native-quality ◆ Already proposed for a state Medicaid agency

The clock that matters is this summer. Every in-scope state must send enrollee notices — by mail plus at least one additional channel — covering compliance, exemptions, consequences, and reporting between June 30 and August 31, 2026. Federal enforcement begins January 1, 2027.

The avoidable failure

Procedural disenrollment, not non-compliance

The last time work requirements ran, the people who lost coverage weren't the people who refused to work. They were the people who never understood what they had to do. That is a communications failure — and it is preventable.

~18,000Arkansans lost coverage in 2018–19 — most for procedural reasons
1 in 4subject enrollees disenrolled before courts halted the program
~0measurable gain in employment from the requirement
43states must now stand up community-engagement requirements

The ten prime contractors pledged more than $600M of verification engines, frailty logic, and fraud tools — and zero priced member-communications products. The system that decides eligibility is being built. The bridge that gets eligible members across it is not.

And the risk just doubled: under the new law, expansion adults must renew every six months instead of annually — twice as many moments a member can fall off coverage over paperwork.

What we do

The member-engagement specialists the primes and health plans plug in

We don't compete with the eligibility-system vendors — we complete them. Everything we build is CMS-compliant, member-comprehension-tested, and delivered in English and Spanish at native quality.

Plain-language notices

CMS-compliant enrollee notices rewritten so members actually understand what they must do, by when, and what happens if they don't — across mail, SMS, and IVR.

Exemption education

The eligible-but-confused caregiver, pregnant member, or person in treatment is the one who churns. We get them to claim the exemption they already qualify for.

Multilingual outreach

Native-quality Spanish and additional languages — built and delivered at scale through our nearshore production line, not machine-translated.

"Am I exempt?" assistant

A plain-language member assistant that answers "Do I need to report?" and "Am I exempt?" and routes the member to the right next step.

Managed outreach

Ongoing, measured SMS / IVR / mail campaigns tied to a retention KPI — your engagement layer, run for you.

Reporting & comprehension testing

Response rates, exemption claim rates, and disenrollment-risk segmentation — so you can prove the coverage you protected.

How it works

From "we have a deadline" to live outreach in weeks

A fast, fixed-scope start that earns the right to a managed program — no long procurement required to begin.

Size the exposure

We quantify the coverage and premium dollars at risk for your population, and pinpoint where members will fall through — by notice, language, and step.

Build the notices & outreach

CMS-compliant, plain-language, English/Spanish notices, SMS/IVR scripts, exemption guides, and an "Am I exempt?" flow — comprehension-tested.

Run it & measure

We deliver the campaign and report response rates, exemption claims, and disenrollment-risk segments — so you can prove the coverage you protected.

Who we serve

Two buyers, one capability

Health plans feel coverage churn as lost premium, month after month. States and their prime contractors are on the hook for the federal notice mandate. We serve both — and we team with the systems vendors rather than fight them.

Medicaid health plans (MCOs)

Every procedurally-disenrolled member is lost capitation premium. We protect enrolled lives with multilingual retention outreach your team can't staff fast enough. See your exposure →

Eligibility-system primes

You own the contract vehicle and the verification engine. We're the multilingual member-communications subcontractor that de-risks your Aug 31 outreach deliverable. Team with us →

State Medicaid agencies

CMS-compliant, plain-language, multilingual notices and exemption campaigns — delivered on the mandate timeline, via your existing vehicle or your prime.

FQHCs & primary care associations

Turnkey multilingual exemption-screening and member-education packs for the trusted community messengers states want involved.

CMS-compliant Plain-language tested English + Spanish native Plan-agnostic Teams with the primes
Why us

We didn't just write about this problem — we proposed to solve it for a state

Our team submitted a proposal to a state Medicaid agency for H.R.1 community-engagement and work-requirement member communications. This is the exact work — not an adjacent capability.

Past performanceSubmitted a state Medicaid work-requirement member-communications proposal
FocusBuilt solely for Medicaid coverage retention — not a general agency
DeliveryU.S.-led, with native-Spanish nearshore production capacity
AccessibilityWCAG 2.1 AA · statement

References and detailed methodology available on request under appropriate confidentiality terms.

For government & health plans

Built to the state outreach scope of work — end to end

State Medicaid outreach contracts (e.g., Illinois HFS's H.R.1 "HRI Project") require a full-service communications partner. We deliver — or subcontract into — every line of that scope.

  • Audience research & segmentation for impacted, priority & hard-to-reach populations
  • Plain-language messaging for diverse Medicaid populations
  • Creative development & accessible production
  • Media planning & buying (pass-through at cost, no markup)
  • Translation & language access services
  • Digital & social media + geofenced ads at clinics, DSS offices, transit & food banks
  • TCPA-compliant SMS/IVR (consent & opt-out) — HHS marketing-rule aware
  • Equity KPI reporting — disaggregated by language, geography & disability
  • Accessibility — Section 508, IITAA & ADA; CBO trusted-messenger partnerships
  • Work-for-hire deliverables; full agency review/approval workflow

Prime contractors: we're your multilingual member-engagement & plain-language subcontractor — and we help you meet BEP / diversity participation goals. Team with us →

Leadership

The rare mix this problem requires: technology, Medicaid, policy, and marketing

Most vendors are strong in one lane. Keeping eligible members enrolled takes all four at once — the systems fluency to work alongside eligibility platforms, the policy command to get the rules right, and the marketing craft to make members actually understand and act.

Tejune is a Harvard Business School alumnus and a technology and marketing executive with 26+ years at the intersection of technology, marketing, and international business growth. He took 6D Global Technologies public on the NASDAQ and has led expansion across the US, Asia, Latin America, Europe, and Africa. A YPO member who has served on boards across multiple industries and continents — and who also studied at Singularity University and Stanford Executive Education — he sets the strategy for turning complex Medicaid policy into clear, multilingual communication that keeps eligible people enrolled.

Harvard Business School Harvard Business School Alumnus · YPO Member

Jeff is an operations and delivery leader with deep experience running healthcare and managed-care programs at scale. He specializes in standing up compliant, high-volume member-engagement operations — outreach, call-center workflows, reporting, and quality — and translating regulatory requirements into dependable day-to-day execution. He leads delivery for every engagement.

Together, deep in technology, Medicaid, policy, and marketing — built specifically to prevent avoidable, procedural coverage loss.

How to start

Engagements that fit the deadline you're facing

Most relationships start with a fixed-scope, fast diagnostic and grow into managed outreach. Start where your pressure is.

Coverage-Loss Exposure Calculator

See the premium / coverage dollars you have at risk. Free, instant.

Free →

Aug 31 Notice & Outreach Rapid Pack

CMS-compliant EN/ES notices, SMS/IVR scripts, and exemption one-pagers — built to close inside the mandate window.

$25–50K · 2–3 wks

Procedural Disenrollment Risk Audit

Notice & member-journey review, gap analysis, multilingual sample pack, and a remediation roadmap.

$25–75K

Churn-Prevention Pilot

A 90-day multilingual outreach + exemption campaign tied to a measured retention KPI.

$50–150K · 90 days

Engagement Layer, Managed

Your ongoing multilingual member-retention outreach, run and measured for you.

$25–100K / mo
Questions

What buyers ask first

What are Medicaid work requirements under H.R.1?

H.R.1 (signed July 4, 2025) requires many Medicaid expansion adults to complete about 80 hours/month of work, volunteering, or education and to report it. States must implement by January 1, 2027, with a federally-mandated enrollee-notice window of June 30–August 31, 2026.

Why do eligible people lose coverage?

Most loss is procedural, not eligibility-based. In Arkansas's 2018–19 program, ~18,000 people lost coverage — mostly from confusion, missed notices, and unclaimed exemptions, not from failing to work. Clear, multilingual communication prevents that.

Do you compete with Maximus, Gainwell, or Deloitte?

No. We don't build eligibility or verification systems. We're the member-communications layer on top of them — and we frequently work as a subcontractor to the primes who need multilingual outreach they don't staff in-house.

How much does procedural disenrollment cost a health plan?

Every procedurally-disenrolled member is lost capitation premium each month. A plan with 100,000 subject members at $450 PMPM and 18% procedural churn has ~$100M/yr at risk. Estimate your exposure →

What's the fastest way to start before August 31?

The Aug 31 Notice & Outreach Rapid Pack delivers CMS-compliant EN/ES notices, SMS/IVR scripts, and exemption one-pagers in 2–3 weeks — built to land inside the federal notice window.

Can you work through our existing contract or prime?

Yes. We engage directly with health plans and states, or as a subcontractor to your eligibility-system prime — whichever path is fastest for your timeline.

Start the conversation

Who is delivering your Aug 31 member-notice obligation?

Tell us your state and population and we'll send back a quick read on your exposure and the fastest compliant path — usually within one business day.

  • No obligation, no procurement required to talk
  • We can engage directly or as a subcontractor to your prime
  • Built for the deadline, delivered in plain language

We reply within one business day.