The instinct when a compliance deadline looms is to staff up the call center. It feels like action. But the call center is an inbound instrument: it answers the phone when a member calls. The members most likely to be procedurally disenrolled under H.R.1 are precisely the ones who will never call, because they do not yet know they need to.
The reachability problem
Medicaid populations move frequently, change phone numbers, and let voicemails fill up. A meaningful share of any plan's contact records are stale on any given day. A call center cannot dial a number that has been disconnected, and it cannot motivate a member who does not perceive a problem. When Arkansas rolled out work requirements in 2018, roughly 18,000 people lost coverage, many because notices and calls never reached them, not because they refused to comply.
An inbound model also has a structural timing flaw. The member-notice window runs June 30 to August 31, 2026, and enforcement begins January 1, 2027. A member who finally calls in December, confused about a letter, is already weeks behind on reporting. The call center caught the contact, but the deadline had already done its damage.
What outreach actually requires
Retention is an outbound, multi-channel, multi-attempt discipline. It means reaching the same member by text, mail, automated call, and live agent, in their preferred language, with each touch reinforcing a single action: report your hours or claim your exemption by this date. It means updating contact records when one channel bounces and routing to another. And it means triggering on data signals, such as a missing report, rather than waiting for the member to notice.
None of this is what a call center optimizes for. Call-center metrics reward average handle time and abandonment rate, which push agents to close conversations quickly, the opposite of the patient, persistent follow-up that retention demands.
Use the call center for what it is good at
This is not an argument to dismantle the call center. It is an argument to stop asking it to do a job it was never designed for. The right architecture pairs an outbound engagement layer that finds and prompts at-risk members with a well-staffed inbound line that handles the calls those prompts generate. The outreach creates demand; the call center absorbs it. Run them as one system, and the call center finally becomes effective, because the right members are now actually calling.