When members lose Medicaid under work or community-engagement rules, the cause is rarely that they are ineligible. More often they are eligible but did not complete a reporting step. This is procedural disenrollment, and its root cause is friction: every additional action between the member and 'done' sheds people who would have qualified.

The math of friction

Picture a reporting path with five steps: receive the notice, find the portal, create an account, locate the right form, and upload a document. If each step loses even 15 percent of users, fewer than half who started will finish, not because they refused, but because something broke along the way. A forgotten password, a portal that does not load on an old phone, a document they cannot find. Each is a small barrier, and small barriers compound.

Arkansas demonstrated this at scale. Reliance on a portal-based reporting process contributed to roughly 18,000 people losing coverage, with about one in four never understanding the requirement applied. Many who did understand still could not navigate the steps. Friction, not ineligibility, drove the losses.

Cutting steps that matter

The single most effective move is collapsing the action to one step. A reply of YES to a text to confirm an exemption. A phone line where a representative records the report so the member uploads nothing. Pre-filled data so members confirm rather than re-enter what the state already knows. Every step you remove is members retained.

Three practical fixes for the run-up to the January 1, 2027 enforcement date. First, default people into known exemptions automatically using existing data rather than making them prove what the agency can already see. Second, make every digital path work on a basic smartphone, because that is what most members have. Third, always offer a non-digital fallback, a phone number or in-person option, so a portal failure is never a coverage failure.

Reducing friction is not a convenience feature. During the June 30 to August 31, 2026 notice window and beyond, the number of steps in the reporting path is a direct lever on how many eligible people keep their coverage. Designing it down is one of the highest-return investments an agency or plan can make.