GAO reissued the report on August 7, 2026, with additional context about recently introduced program-integrity legislation. The 20 programs accounted for about $1.1 trillion in federal obligations during fiscal year 2025, nearly 90% of comparable obligations among programs exceeding $100 million.

The finding concerns safeguards and documentation. It does not mean that the $1.1 trillion in obligations, or the broader $1.2 trillion in federal assistance, was stolen or improperly paid.

Programs reach households through states and other intermediaries

The federal programs reviewed by GAO include Medicaid, the Supplemental Nutrition Assistance Program, disaster assistance, education, transportation, housing and community development. Benefits and grants may be distributed through state agencies, local governments, tribes, territories, schools, colleges, contractors, subrecipients and other nonfederal organizations.

GAO estimated that the federal government provided $1.2 trillion in assistance to state and local governments in fiscal year 2025. The $1.1 trillion figure for the 20 selected programs refers to federal obligations, which are commitments to spend money that may be paid during the same fiscal year or a later year.

That decentralized structure can help deliver services but also creates additional points where eligibility decisions, payments, contracting and oversight can break down.

What the five-versus-15 finding means

A fraud-risk assessment is a management tool. It helps an agency identify where fraud could occur, evaluate the likelihood and potential impact, and prioritize prevention, detection and response efforts.

Five of the 20 programs supplied documentation consistent with those leading practices. The remaining 15 did not provide comparable documented evidence. GAO said that group included programs with no assessment as well as programs for which agencies supplied limited or insufficient documentation.

The absence of a documented assessment does not establish that fraud occurred in a program. It does show that GAO could not find comparable evidence that most of the reviewed programs were systematically identifying and ranking their program-specific fraud risks.

Audit findings point to broader control weaknesses

GAO also identified severe and persistent single-audit findings in 18 of the 20 programs, using complete data from 2020 through 2024. Single audits examine how federal funds are managed by states, local governments and other recipients and whether required controls are working.

GAO describes severe and persistent findings as indicators that programs may lack safeguards to prevent, detect or respond to fraud. They are not equivalent to confirmed fraud. Examples cited in the report include inadequate verification of medical services, unauthorized access to Medicaid payment systems and weaknesses involving road and bridge materials.

Across the 18 programs with such findings, about 4% of nearly 90,000 single audits had severe and persistent findings. The rate varied widely by program, from about 0.3% to nearly 25%.

The report also identifies 22 open GAO recommendations related to fraud-risk management. Follow-up will show whether agencies document program-specific risks, improve data verification and analytics, and address weaknesses identified through audits.

Improper payments are a separate measure

In a separate analysis, GAO reported that 15 federal agencies estimated about $186 billion in improper payments across 64 programs in fiscal year 2025. That figure is not a fraud total. Improper payments can include payments made to the wrong recipient, in the wrong amount, or without enough documentation, and may result from administrative error as well as fraud.

GAO says the $186 billion estimate does not represent the full extent of government-wide improper payments. For example, the Temporary Assistance for Needy Families program, or TANF, did not report an estimate even though about $16.5 billion was spent through the program in fiscal year 2025. The Department of Health and Human Services has said it lacks authority to obtain the information needed to estimate and report TANF improper payments.

What happens next

Congressional oversight and agency action will determine whether the documented gaps lead to stronger controls. H.R. 7155, the Stop Fraud in Federal Programs Act of 2026, was introduced in the House on January 20, 2026, and referred to the Judiciary Committee and the Education and Workforce Committee. It remains a proposal, not an enacted law.

For recipients, the report does not immediately change eligibility, benefit amounts or application procedures. For taxpayers and policymakers, the key questions are whether agencies close the 22 open recommendations, use information across programs and publicly document how they are reducing fraud risk without blocking eligible people from benefits and services.

Sources

• GAO fraud-risk report, reissued August 7, 2026
• Congress.gov, H.R. 7155

The project involves multiple Hayward addresses. Subsequent reporting cited 76 megawatts of backup-generating capacity. That figure describes reported backup capacity, not necessarily the project’s continuous electricity consumption.

Residents question scale and oversight

Residents raised concerns about the project’s size and potential demand on the electric system. The development has also prompted broader questions about whether Hayward’s existing rules adequately address data centers and whether public-benefit requirements are sufficient for projects of this scale.

The approval occurred at the Planning Commission level. The development’s advancement before a full City Council decision has become part of the public concern surrounding the project. No City Council approval or rejection is identified here.

The project could affect Hayward’s electricity infrastructure, industrial land use, emissions and traffic. Those possible effects are part of the reason the data center has become a city planning issue rather than only a private development matter.

Next listed commission meeting

The city’s next listed Planning Commission meeting is scheduled for Aug. 27, 2026. The meeting is the next identified point on the commission calendar for additional public discussion or action related to planning matters.

The approval date and vote tally require confirmation from the underlying commission minutes or resolution. The project’s application number, final approval conditions, total site acreage and projected permanent jobs are also not identified in the public details summarized here.

USDA published the final rule on May 7, 2026. Under the new standard, participating retailers must offer seven varieties of items across four staple-food categories: protein, grains, dairy, and fruits and vegetables.

The agency said the requirement more than doubles the prior minimum number of available foods. The rule also increases requirements for perishable foods and removes loopholes that allowed some snack foods to count toward a retailer’s staple-food obligations.

What SNAP retailers will have to stock

The rule applies to retailers authorized to accept SNAP benefits across the United States. That includes stores serving communities with different shopping options, including small and rural retailers where a participating store may be an important place for SNAP recipients to buy food.

The seven-variety requirement covers four broad categories: protein, grains, dairy, and fruits and vegetables. Retailers will also face stronger requirements involving perishable foods, while foods that do not qualify as staples will no longer be able to fill the same role through the snack-food loopholes addressed by the rule.

In practical terms, the change concerns the selection of food that participating stores must keep available. It does not change the amount of SNAP benefits available to recipients, and USDA has not said that the rule will lower food prices or produce specific health outcomes.

The Food and Nutrition Service said the purpose of the final rule is to ensure that stores participating in SNAP offer a broader selection of staple foods. The rule therefore places new compliance obligations on retailers while changing the food options available through the program’s authorized retail network.

A large retail network

SNAP-authorized retailers collectively accept more than $90 billion in SNAP transactions each year, according to USDA. Those stores are a major part of how SNAP participants use their benefits to purchase food throughout the country.

USDA also said nearly 3,200 retailers had faced agency action since the beginning of the Trump administration for failing to meet stocking standards or for failing to maintain those standards after authorization.

That figure describes enforcement actions cited by the agency. It does not establish that every retailer covered by the new rule has violated current requirements. The final standard applies nationwide to all retailers authorized to accept SNAP benefits.

Implementation is scheduled for fall

The new requirements are scheduled to take effect in fall 2026. USDA’s announcement did not identify a particular day within that season, so retailers and SNAP participants will have to await further implementation information from the agency.

The Food and Nutrition Service said it would issue additional guidance for retailers in the following weeks. That guidance is expected to provide more information about how stores should meet the seven-variety standard, comply with the higher perishable-food requirements and maintain their authorization.

Until the new rule takes effect, retailers remain subject to the standards currently in force. After implementation, stores will need to offer qualifying foods in the required categories rather than relying on disallowed snack-food substitutions to satisfy the stocking rules.

The change will be felt most directly by retailers that accept SNAP and by customers who use the program at those stores. For retailers, the final rule means expanded stocking and compliance responsibilities. For SNAP participants, it establishes a broader minimum range of staple foods that authorized stores must carry once the fall 2026 implementation begins.

DHS listed the event from 10 a.m. to noon at Greenville Public Library, 573 Putnam Pike, Greenville, RI 02828. The two-hour event was an official state-agency outreach activity, according to the department’s event listing.

A local point of access

The practical change for residents was the location of the state-service contact. The outreach brought DHS information and assistance to a familiar Greenville institution, allowing residents to seek help locally rather than traveling to a distant state office, according to the approved event information.

That made the library the identified local venue for contact with the state human-services agency on the listed date. Greenville Public Library’s official materials confirm the institution named in the DHS notice and support its identification as the Greenville location at 573 Putnam Pike.

The event could be relevant to residents trying to understand or access public benefits and other DHS services. The available record, however, does not say which individual programs were represented, what staff services were available or whether residents could complete a particular application or case action at the event.

What the record confirms

The DHS listing identifies July 15, 2026, as the event date and 10 a.m. to noon as the time window. The event record describes the activity as outreach at Greenville Public Library, rather than as a general community-calendar or promotional listing.

The approved sources do not provide an attendance figure. They also do not report what assistance residents sought, how many people received help, whether any benefits were approved or distributed, or what outcomes followed the two-hour session.

Those limits matter because the event should not be described as proof of demand, resident satisfaction or successful benefit applications. The available information establishes that DHS brought an official outreach activity to the library; it does not establish the results of individual contacts made there.

No recurring service identified

The record also does not identify a next event, follow-up deadline or recurring schedule. It does not establish that Greenville Public Library became a permanent DHS office or that the agency will regularly provide services there.

For now, the confirmed development is a completed state-agency outreach event at 573 Putnam Pike on July 15, 2026. Further details about the specific programs offered, attendance, resident outcomes or future outreach would require additional records beyond the approved event listing.

From Oct. 1 through Nov. 30, 2026, enrollees may remain in their current managed-care plan or request a different one. Any requested plan change will take effect Dec. 1, according to the Florida Agency for Health Care Administration.

Key dates for Medicaid beneficiaries

• July 2026: AHCA began sending open-enrollment reminder letters.
• Sept. 30: AHCA expects to complete the open-enrollment mailings.
• Oct. 1-Nov. 30: Beneficiaries may keep their plan or request a change.
• Dec. 1: Requested plan changes take effect.

Receiving a letter does not mean a beneficiary must choose a new plan. Those satisfied with their current coverage can remain enrolled without making a change.

How to keep or change a plan

Beginning Oct. 1, beneficiaries can request a plan change in three ways:

• Text ENROLL to FLSMMC (357662). Enrollees should have each member’s Medicaid identification number and account PIN available.
• Use the Florida Medicaid managed-care website’s member portal or enrollment virtual assistant.
• Call 1-877-711-3662 to speak with a Choice Counselor.

A plan change is not immediate. Requested changes become effective Dec. 1, 2026.

Check provider networks before switching

Beneficiaries considering a change should verify that the prospective plan includes the doctors, specialists, pharmacies, hospitals and behavioral-health providers they use. They should also check coverage for prescriptions, transportation and other active services.

AHCA’s open-enrollment notice does not guarantee that a current provider will remain in-network after a regular managed-care plan change. Beneficiaries should ask the prospective plan or a Choice Counselor about network participation and any transition details before making a selection.

A separate option for some adults with disabilities

Florida also has a separate voluntary enrollment and transfer opportunity for some adults with intellectual and developmental disabilities through the Intellectual and Developmental Disabilities Comprehensive Managed Care Program, known as ICMC.

A person may be eligible if they:

• Reside in Florida and are eligible for Medicaid;
• Are at least 18 years old;
• Have a qualifying developmental disability under Florida law; and
• Are in an iBudget waiver pre-enrollment category.

Eligibility also depends on available space. As of July 1, 2026, people already enrolled in the iBudget waiver or the Statewide Medicaid Managed Care Long-Term Care program may be able to transfer into ICMC if they meet the criteria.

ICMC is a statewide Medicaid program administered through Florida Community Care. It combines regular Medicaid medical services with home- and community-based services similar to those offered through the iBudget waiver. AHCA says eligible participants can call 1-877-711-3662 and select option 4 to ask about eligibility or begin enrollment.

ICMC is not an option for every Medicaid recipient, and enrollment is voluntary. People considering it should ask how the change would affect their current services, providers and placement on the iBudget pre-enrollment list.

What continuity-of-care protection applies

For qualifying ICMC enrollees who are moving from another program, Florida requires Florida Community Care to make continuity-of-care payments to qualifying out-of-network providers already serving the enrollee before the effective date of enrollment or transfer.

That continuity-of-care period lasts 180 days from the date of enrollment. The provision applies to the ICMC transition and should not be treated as a guarantee that every provider will remain available after any Medicaid plan change.

Public comments remain open on proposed ICMC changes

AHCA is accepting public comments through Aug. 28, 2026, on a proposed amendment to the ICMC waiver.

The amendment remains a proposal, not a final change approved by the federal Centers for Medicare and Medicaid Services. AHCA will consider comments before deciding whether to submit the request to CMS.

Comments can be emailed to FLMedicaidWaivers@ahca.myflorida.com or mailed to the Bureau of Medicaid Policy, Agency for Health Care Administration, 2727 Mahan Drive, MS 20, Tallahassee, Florida 32308.

What Florida beneficiaries should do now

• Watch for an AHCA reminder letter by Sept. 30.
• If considering a switch, compare provider networks, prescriptions, hospitals, behavioral-health services, transportation and other active care needs before Nov. 30.
• Keep a Medicaid ID number and account PIN available if using the text-enrollment option.
• Remember that a requested plan change will not take effect until Dec. 1, 2026.
• If asking about ICMC, call 1-877-711-3662 and select option 4 to confirm eligibility, available space and provider-continuity arrangements.

For regular managed-care enrollment questions, beneficiaries can call 1-877-711-3662. No action is required simply because open enrollment begins.

Sources

• Florida AHCA ICMC Program
• Florida Medicaid ICMC coverage update

The rule was published in the Federal Register on July 20, 2026, and takes effect September 18, 2026. It applies to applications for admission made on or after that date and to adjustment-of-status applications postmarked or submitted electronically on or after that date.

What changes on September 18

The final rule rescinds the public-charge regulations adopted in 2022. Those regulations defined the benefits that could be considered, listed regulatory exemptions and established a more structured framework for determining whether an applicant was likely to become a public charge.

Under the new rule, DHS is removing those regulatory definitions, the specified benefit list, the prior structured minimum-factor framework and the regulatory list of exemptions and waivers. Officers will instead be able to consider means-tested public benefits, the statutory factors and other individualized facts under a totality-of-the-circumstances review.

DHS says the change will restore broader discretion and allow more individualized decisions. The Federal Register says USCIS will issue subregulatory guidance on or before September 18 to inform, but not prescribe, officers’ determinations.

How the transition works

The date an application is filed or submitted matters. Applications for admission made before September 18 are not governed by the new rule. Adjustment-of-status applications postmarked or filed electronically before that date also fall outside the new rule’s application timing.

The final rule says receipt of means-tested public benefits before September 18, 2026, will be considered consistently with the 2022 framework. That framework focused on a narrower set of benefits and circumstances. On or after the effective date, DHS says it will consider receipt of any means-tested public benefits along with other relevant case-specific facts.

The rule does not mean that receiving public benefits automatically results in denial of a visa or green-card application. Officers must assess the applicant’s circumstances as a whole, and the applicable legal standard, statutory exclusions and other protections can vary by immigration category and type of application.

Why families may feel the effects

The policy could affect households that are trying to balance immigration applications with health care, food or housing needs. In mixed-status families, a U.S. citizen child or another household member may receive benefits even when the immigrant applicant is not the direct recipient. Families may still worry that enrollment, household finances or other circumstances could affect an immigration review.

The Associated Press reported that advocates and public-health experts expect the rule to create confusion and discourage some eligible people from seeking assistance. That concern is commonly called a chilling effect: people avoid programs they are legally allowed to use because they fear immigration consequences.

Reuters reported that food assistance and Medicaid could be relevant under the broader approach. The final rule does not create a new closed list of programs, which is one reason the USCIS implementation guidance will matter.

DHS estimates billions in forgone benefits

DHS estimates that federal and state benefit transfers could decline by about $13.05 billion annually as people in households that include immigrants disenroll from or forgo enrollment in public-benefit programs.

That figure is a projection, not a confirmed reduction already occurring. DHS says the estimate is uncertain and could be affected by other policy changes, including separate changes to Medicaid and the Supplemental Nutrition Assistance Program. The agency also says reduced benefit transfers could affect health-care providers, grocery retailers, landlords and other parts of local economies.

What to watch next

USCIS is directed to issue subregulatory implementation guidance on or before September 18. That guidance should help explain how officers will apply the broader discretion, what evidence applicants may need and how different immigration categories are treated, although the Federal Register says the guidance will inform rather than prescribe individual outcomes.

People considering an immigration filing should not assume that using a benefit guarantees denial or that every program is treated the same way. Because the rule’s practical application may depend on the case, the benefit involved and the final USCIS guidance, applicants should consult a qualified immigration attorney or an accredited representative before changing benefits or filing strategy.

Sources

• Federal Register: Public Charge Ground of Inadmissibility, 91 FR 45324
• Associated Press: Trump administration revives rule that may deny green cards to immigrants using public benefits
• Reuters: US to revive rule that could deny green cards to immigrants using public benefits
• USCIS: Public Charge

The state is using $8.5 million from its Federal Cuts Response Fund for the program. The Department of Social Services arranged the distribution with Connecticut’s network of community action agencies, with support from the Connecticut Association for Community Action.

Who qualifies for the $300 benefit

The benefit is limited to individuals who lost SNAP eligibility because of the federal Able-Bodied Adults Without Dependents, or ABAWD, work-rule changes since Dec. 1, 2025, and who are no longer receiving SNAP.

Residents should look for a DSS notice stating that they did not meet the ABAWD requirements and reached the three-month SNAP benefit limit. Eligibility is confirmed when the resident requests the grocery benefit through a local community action agency.

The benefit is issued per eligible individual, not per household. A household could therefore receive more than one $300 benefit if multiple individuals meet the eligibility requirements. Losing SNAP eligibility because of ABAWD rules also does not necessarily end benefits for everyone in the household; other members may remain eligible.

How to request the grocery card

DSS says affected residents should contact the community action agency serving their location. The agencies are handling outreach, eligibility verification and card distribution. Residents should not wait for the money to appear on their regular EBT card.

The statewide contact path depends on where a resident lives. DSS directs people who lost SNAP because of the federal work-rule changes to reach out directly to their local community action agency.

As one local example, Community Renewal Team is working with DSS on the grocery-card program for residents in Hartford and Middlesex counties. It lists SNAP outreach numbers of 860-560-5765 for Hartford County and 860-347-4465, extension 227, for Middlesex County. Residents elsewhere should use the community action agency serving their area rather than assume those numbers apply statewide.

How the prepaid benefit works

The grocery benefit comes as a prepaid virtual Mastercard or Visa. It can be used at food retailers that accept standard credit cards, but it is intended for purchases that generally qualify under SNAP rules.

The card does not expire, according to the state. Any unused balance remains available until it is spent. Receiving the benefit does not affect a recipient’s eligibility for other assistance programs.

How this differs from regular SNAP

The $300 payment is a one-time, state-funded bridge. It is not a replacement for ongoing SNAP and is not an automatic deposit into a household’s EBT account.

Residents who remain eligible for SNAP should continue following DSS instructions for renewals, reporting changes and maintaining benefits. A household should also check whether other members continue to qualify even if one individual lost benefits under the ABAWD rules.

Where to get additional help

DSS directs residents who need food pantries, soup kitchens or mobile food assistance to 2-1-1 Connecticut and Connecticut Foodshare. The DSS Benefits Center can be reached at 855-626-6632 from 8 a.m. to 4 p.m. Monday through Friday.

Residents who received a notice about losing SNAP under the ABAWD rules should keep that notice available when contacting their local community action agency. The state’s Aug. 4 rollout announcement does not mean every potentially eligible person has already received a card; access is being handled through local agencies after eligibility is verified.

Sources

• Connecticut DSS SNAP Eligibility 2026 guidance
• Community Renewal Team SNAP outreach

The lawsuit challenges a modified Health and Human Services Administration for Children and Families system-of-records notice for TANF data. The notice is not a court ruling and does not change TANF eligibility, benefit amounts or application procedures. Instead, it describes how records and verification information may be collected, used and disclosed for federal oversight and program-integrity reviews.

What the federal notice changed

The Federal Register notice became effective June 23, 2026. A new routine-use provision allowing certain disclosures for program-integrity reviews became effective July 23, 2026.

The notice says TANF data reported by state, territorial and tribal grantees may include family-level information such as county of residence, ZIP code, household size, case number and the type and amount of assistance received. Adult and minor-child records may include Social Security numbers, dates of birth, citizenship or immigration status, employment status, education information, work-activity hours and income.

Verification information obtained from TANF agencies, other HHS records or other government agencies may include names, addresses, Social Security numbers, dates of birth and detailed immigration-status information. The notice identifies the Department of Homeland Security and the Social Security Administration as examples of possible sources.

ACF says the system is used to determine whether grantees are ensuring recipient eligibility and to oversee compliance through activities including program-integrity reviews, audits, fraud investigations and monitoring. The new routine use allows disclosures to another federal or grantee agency, or to an entity engaged by ACF, to assist with those reviews, including verification of citizenship or immigration status. The notice says each proposed disclosure must be evaluated for legal permissibility.

What the states are asking the court to do

The states’ complaint seeks to stop the challenged data-sharing practices. It argues that the administration exceeded its authority, violated privacy protections and interfered with the states’ role in administering welfare programs. Those are allegations in the lawsuit, not findings by the court.

The states listed as joining the case are Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, Virginia, Washington and Wisconsin, along with the District of Columbia. The governors of Kentucky and Pennsylvania also signed onto the suit, according to The Associated Press.

The defendants include federal officials and agencies responsible for the challenged records system, including HHS and ACF. ACF declined to comment to AP on August 3.

Why the dispute reaches across the country

TANF is a federal block-grant program administered through the 50 states, the District of Columbia, U.S. territories and tribal governments. The program provides more than $16 billion in federal grants, which states and other grantees may use for cash assistance, work programs, job training and related services for low-income families.

Because TANF records are collected and maintained through state, territorial and tribal programs, the case could affect how agencies respond to federal verification requests and what safeguards they apply when sharing recipient information.

What it means for recipients

The lawsuit concerns data access and governance. It does not announce a nationwide change to TANF eligibility, benefit amounts or application procedures. It also does not establish that the federal government is using TANF records for immigration enforcement.

The notice describes categories of information and possible disclosures; it does not mean every listed field will be released in every review. ACF says the records are subject to security, confidentiality and access controls.

What to watch next

The next important developments will be the federal response, any request for a temporary restraining order or preliminary injunction, and court decisions on whether the states can temporarily block the challenged data-sharing practices.

Later filings may clarify the states’ statutory and constitutional arguments, the administration’s interpretation of its oversight authority and how TANF agencies should handle federal information requests while the case proceeds.

Sources

• Federal Register: Modified TANF System-of-Records Notice
• Associated Press: States sue over access to social-service data
• HHS TAGGS: TANF assistance listing

This is not a blanket work mandate for every HUSKY member, and January 1, 2027, is not a completed Connecticut coverage cutoff. The requirement generally applies to HUSKY D adults ages 19 through 64 who do not live with a child under 14 and are physically and mentally able to work.

Who is affected

HUSKY D is Connecticut’s Medicaid coverage for many low-income adults who do not qualify through another Medicaid category. According to DSS, HUSKY A, B and C members are not subject to this specific HUSKY D change.

The federal interim final rule was published June 3, 2026, became effective July 31, 2026, and requires applicable states to implement the requirement no later than January 1, 2027. States may establish an earlier implementation date, but Connecticut has not announced a final fixed schedule for every notice, verification or review step.

How residents can meet the requirement

An affected HUSKY D member may satisfy the monthly standard in several ways. The federal rule and Connecticut’s guidance list:

• Monthly income of at least $580;
• At least 80 hours of work per month;
• At least 80 hours of community service per month;
• At least 80 hours in a qualified work or training program; or
• Enrollment at least half-time in an education program.

The $580 figure comes from multiplying 80 hours by the $7.25 federal minimum wage cited in the rule. It could change if the federal minimum wage changes.

Federal rules also allow combinations of qualifying work, community-service, work-program and less-than-half-time education activities totaling at least 80 hours in a month. However, the rule generally does not allow education hours to be combined with another activity when a person is enrolled at least half-time. Residents should not assume that every type of activity can be added together.

Exemptions and deemed-compliant categories

DSS lists several groups that are generally not affected by this specific HUSKY D requirement or may be treated as meeting it. They include parents and caregiver relatives, people who are pregnant or postpartum, foster and former foster youth, American Indian or Alaska Native individuals, and veterans with a 100% schedular disability rating or a total disability rating based on individual unemployability.

Other categories listed by DSS include people who were in jail or prison within the previous 90 days, people with Medicare Part A or B, people recently receiving inpatient hospital or nursing-facility care, people in substance-use treatment, and people who already meet certain Temporary Family Assistance or SNAP requirements.

DSS also lists medical frailty. A diagnosis alone does not automatically establish that exemption. Connecticut reporting on the federal guidance says the state may need to show both a qualifying medical condition and evidence that the condition significantly impairs the person’s ability to meet the community-engagement requirement. Connecticut’s operational process for that medical review remains unsettled.

What the state says residents should do now

DSS has created a HUSKY D work-rules prescreener for residents who are unsure whether the changes apply to them. The department advises members to keep their contact information current and report jobs, current education, volunteer work or training when applying, renewing coverage or reporting a change.

For HUSKY Health documentation, DSS directs members to report changes and provide documents through Access Health CT. DSS says it will notify members if the changes affect them or if additional information or documents are needed. Residents should keep records of dates, hours, employers, schools, training programs and volunteer supervisors, while recognizing that Connecticut may issue more specific instructions before implementation.

How many people could be affected

Connecticut officials estimate that roughly 110,000 of about 316,000 HUSKY D recipients could be at risk under the federal changes. That is an estimate of potential exposure, not a projection of completed coverage terminations. The figure may change as the state confirms exemptions, existing compliance and qualifying activities.

The scale matters beyond individual coverage. CT Mirror reported that hospitals, community organizations and state officials are concerned about residents losing regular access to care. The final effect will depend in part on how Connecticut verifies eligibility, identifies exemptions and reaches people who need help.

Where to get help

Residents can start with the DSS H.R.1 work-rules toolkit and HUSKY D prescreener. Access Health CT can help with HUSKY applications, renewals and documentation. Connecticut’s regional Community Action Agencies provide free, local assistance with understanding eligibility rules, responding to changes, completing paperwork or renewals, and connecting with local help for housing, transportation, health care and food.

If you receive HUSKY D and are between 19 and 64, do not live with a child under 14 and believe you may be able to work, review the prescreener before January 1, 2027. If you are pregnant, a caregiver, recently hospitalized or incarcerated, medically frail, in treatment, a qualifying veteran or otherwise covered by an exemption, review the state’s list rather than assuming you must document 80 hours.

Because Connecticut’s final verification and review procedures are still being built, residents should watch for notices from DSS or Access Health CT, keep contact information updated and avoid assuming that a diagnosis, volunteer activity or partial participation automatically qualifies.

Sources

• Connecticut DSS H.R.1 work rules toolkit
• Federal Register Medicaid community-engagement rule
• CT Mirror: About 110,000 poor CT adults could lose Medicaid coverage

The Pennsylvania Department of Human Services is processing individual applications on a rolling basis. The benefit is issued as one summer payment, equal to $40 for each of the three summer months, and can be used to buy groceries at participating retailers.

Applications received after Aug. 31 can still be submitted, but they will be considered for the summer 2027 program rather than the 2026 benefit. DHS says issuances for approved Summer 2026 applications will be completed by October 2026.

Why the benefit matters

SUN Bucks is intended to help families cover grocery costs when children are out of school and regular school-year meal programs are unavailable. DHS estimates that about 1.3 million Pennsylvania children will qualify for the 2026 program.

The state began distributing automatic benefits in June. DHS said approximately 860,000 automatically eligible children were included in the first distribution. A July 15 update described a second and final automatic distribution for about 235,000 additional children, while individual applications continue to be processed separately.

Who receives SUN Bucks automatically

Many eligible children do not need to apply. Automatic eligibility generally includes children in households that received SNAP or Temporary Assistance for Needy Families, or TANF, during the applicable program period.

Children receiving Medicaid with income that qualifies for the National School Lunch or School Breakfast Program may also be automatically eligible. Other automatic categories include children determined eligible for free or reduced-price school meals and certain children who are homeless, in foster care, runaway, migrant or enrolled in Head Start, when the program and school-participation rules apply.

Families should not assume that receiving free meals at school automatically guarantees SUN Bucks. Students at schools using the Community Eligibility Provision, where meals are provided without individual applications, may need to qualify through another category or submit a SUN Bucks application.

Check before applying

Pennsylvania DHS recommends using its SUN Bucks Eligibility Navigator first. The tool helps families determine whether a child qualifies and whether the benefit should arrive automatically or requires an application.

This step can help prevent households from submitting an unnecessary application while also identifying families who may otherwise miss the Aug. 31 deadline.

How to apply

Households that need to apply can submit an online application, mail a paper application or request assistance through a County Assistance Office.

Applicants should be prepared to provide information about each child, including the child’s age, birth date, school and mailing address, as well as household income. DHS says applicants do not need to provide a Social Security number, proof of citizenship or pay stubs. Providing a Social Security number or an existing case number, if available, may help with processing but is not required.

How the benefit arrives

Families that already have a SNAP or TANF electronic benefits transfer card may receive SUN Bucks on that existing card. Households without an eligible card may receive a separate Summer EBT card by mail.

DHS says eligible application-based benefits will be issued on a rolling basis. Families should not assume that applying in August means the benefit will arrive before the end of summer; the state’s target is to complete Summer 2026 application issuances by October.

What to do if you have questions

Families can use the Eligibility Navigator, review Pennsylvania’s SUN Bucks information or call the SUN Bucks FAQ line at 1-877-762-1575.

The key deadline is Aug. 31, 2026: an application received by that date can be considered for the 2026 $120 benefit, while a later application will be considered for summer 2027.

Sources

• Pennsylvania DHS SUN Bucks program page
• Pennsylvania SUN Bucks application portal
• Pennsylvania 2026 SUN Bucks school FAQ

HFS says the change is required by federal law and was not initiated by Illinois. The agency is urging customers to update their contact information and immigration-status records so notices reach them and eligibility can be assessed using current information.

What the notices mean

HFS mailed an awareness letter dated July 6, 2026, to Illinois households with a noncitizen resident. That letter was not a final termination notice, and HFS says some households that received it will not be affected.

A second mailing expected in August will go to customers HFS identifies as directly affected by the federal changes. Residents should rely on that personalized notice rather than assuming coverage will end based only on the July awareness letter.

For people outside the continuing eligibility categories, coverage is scheduled to remain in place through September 30. The federal eligibility changes take effect October 1.

Who may be affected

HFS says some lawfully present immigrants may lose federally funded Medicaid under the new rules. The potentially affected groups include some refugees and asylees, humanitarian parolees, survivors of domestic violence or human trafficking, Amerasian immigrants who have not adjusted to lawful permanent resident status, people granted withholding of removal and certain conditional entrants. The HFS toolkit says the list also includes some other protected humanitarian categories.

That list does not mean every person in those categories will lose coverage. Eligibility depends on the person’s complete case record, current immigration status and whether another continuing eligibility category applies.

Who remains eligible

HFS identifies several groups that remain eligible under its guidance. They include naturalized citizens; lawful permanent residents who have met or are exempt from the federal five-year eligibility bar; certain Cuban and Haitian entrants; and migrants from countries covered by the Compact of Free Association, including the Marshall Islands, Micronesia and Palau.

Children younger than 19 and pregnant people remain among the listed eligible groups. HFS also identifies people with 40 qualifying U.S. work quarters, veterans or active-duty military members and their spouses, and people already enrolled in the Health Benefits for Immigrant Seniors program.

HFS lists several state-funded programs as continuing coverage categories, including Medical Benefits for Asylum Applicants and Torture Victims, the Illinois medical program for survivors of domestic violence, the Illinois kidney or renal disease program and Health Benefits for Immigrant Seniors. HFS’s toolkit also references coverage for victims of trafficking, torture or other serious crimes.

What customers should do now

HFS recommends checking and updating a household’s address, phone number and email address. Customers should also update immigration-status information and provide documentation of changes when requested. Updating records does not guarantee continued coverage, but it helps HFS assess the case using current information and deliver notices.

Updates can be made through ABE Manage My Case, at a local Family and Community Resource Center, or by calling the All Kids Unit at 1-877-805-5312. The TTY number is 1-877-204-1012. People who need help navigating the change can contact an Immigrant Resource Program partner at 1-855-435-7693.

HFS also advises customers to schedule needed care and refill prescriptions before October 1 when appropriate. Those steps are preparation for a possible coverage change, not a guarantee that coverage will continue.

What care may remain available

Some people who lose full-scope Medicaid because of the new federal noncitizen rules may still qualify for Emergency Medicaid if they meet the other eligibility requirements. HFS describes that coverage as limited, time-bound assistance for qualifying emergency medical services, not regular comprehensive coverage. The toolkit says Emergency Medicaid generally applies to people age 19 and older who are otherwise eligible except for their immigration status.

Federally qualified health centers and free or charitable clinics may provide primary and preventive care to uninsured and underinsured patients regardless of immigration status or ability to pay, according to HFS. Hospitals may also have charity-care programs, and uninsured patients can ask hospital financial counselors about available assistance.

The change is separate from Illinois’s earlier reduction of state-funded coverage for some immigrant adults. The Associated Press reported that safety-net providers in the Chicago area have been serving people affected by those earlier coverage losses and have warned that gaps in insurance can make it harder for patients to obtain preventive care. That earlier state-program change is not the same policy change taking effect October 1.

Where to get help

Customers should watch for the August personalized HFS notice and review it carefully. Questions about a specific case can be directed to HFS at 1-877-805-5312 or to the Immigrant Resource Program partner line at 1-855-435-7693.

Residents should not disenroll or assume they are ineligible solely because they received the July awareness letter. The key dates are September 30, 2026, when coverage is scheduled to end for people outside the continuing categories, and October 1, 2026, when the new eligibility rules take effect.

Sources

• Illinois HFS: Health Benefits for Immigrants
• Associated Press: Medicaid for immigrants in U.S. illegally being limited or ended in three states

CMS says states must begin conditioning Medicaid eligibility for certain adults on community engagement beginning January 1, 2027, unless a state starts sooner. The underlying law describes the Medicaid provision as effective December 31, 2026. At the same time, an enacted federal law is reducing the federal share of allowable SNAP administrative costs from 50% to 25% beginning in fiscal year 2027. States with high SNAP payment-error rates may also become responsible for part of their benefit costs, generally beginning around October 1, 2027.

The changes are forcing states to weigh technology upgrades, caseworker staffing, outreach, verification procedures and budget requests. The National Governors Association said state policy advisers are reporting shared concerns about Medicaid implementation, SNAP administration and the financial exposure created by payment errors.

Who could face the Medicaid requirement

The Medicaid rule does not apply to every enrollee. It targets certain nonpregnant, nondisabled adults ages 19 through 64 who are enrolled or applying through the Affordable Care Act Medicaid expansion pathway or specified waiver coverage.

Those individuals generally must complete at least 80 hours per month of qualifying activity. Activities can include work, participation in a work program, community service or enrollment in an education program at least half time. The law and federal guidance provide mandatory exemptions and hardship provisions, while some procedures will depend on federal guidance and state implementation choices.

For new applicants, states may require proof of qualifying activity for one month before application, or up to three consecutive months at state option. Existing enrollees may have to demonstrate compliance as a condition of continued coverage. CMS’s public implementation page uses January 1, 2027; the Congressional Research Service describes the statutory effective date as December 31, 2026, or sooner at state option.

The work ahead for state Medicaid agencies

CMS says the requirement will require major system, policy and operational changes. States will need ways to verify qualifying activity, accept and review documentation, send notices, report compliance and communicate exemptions and deadlines. Federal law also requires advance outreach to people who may be subject to the requirement.

That work may require changes to eligibility systems, call centers, online portals and contracts with workforce or community-service providers. It also may increase demand for caseworkers and outreach, particularly when people have irregular work schedules, limited internet access or difficulty obtaining records.

States are not all following the same path. Associated Press reported that Nebraska Gov. Jim Pillen announced an earlier launch, while Missouri officials requested about $33 million for technology improvements and more than $12 million for the equivalent of about 120 additional positions. Those are state-specific examples, not a national cost estimate.

SNAP costs are arriving on a different timetable

SNAP’s work-rule changes and Medicaid’s community-engagement requirement do not share the same effective date. The Congressional Research Service says the new SNAP provisions were effective upon enactment, with USDA guidance requiring state implementation by November 2, 2025. The Medicaid community-engagement provision takes effect at the end of 2026, or sooner if a state chooses.

SNAP’s administrative-cost shift is also moving through a separate rulemaking process. USDA’s June 24 proposed rule would codify an enacted statutory change reducing the federal share of allowable state administrative costs from 50% to 25% beginning in fiscal year 2027. The rule remains proposed, and comments are due August 24, 2026. SNAP Employment and Training administrative costs and related participant reimbursements remain subject to separate 50% reimbursement rules under the proposal.

USDA also reported a national SNAP payment-error rate of 10.62% for fiscal year 2025, above the 6% threshold in the 2025 law. Under the new framework, states at or above the threshold may have to match 5%, 10% or 15% of their states’ benefits, depending on the error rate. USDA says that financial responsibility will generally begin as soon as October 1, 2027, and that states may use their fiscal year 2025 or 2026 error rate for the first year.

A payment error is not the same as fraud. USDA says the measure tracks how accurately states determine eligibility and benefit amounts and includes both overpayments and underpayments. Errors can result from inaccurate calculations, missed household updates, procedural mistakes or other largely unintentional problems involving the state agency or a household.

What households should watch

People receiving both Medicaid and SNAP may encounter overlapping but different rules. Both programs use an 80-hour standard in some circumstances, but their covered populations, exemptions, qualifying activities, reporting requirements and effective dates are not identical. The Congressional Research Service estimates that some people in the potentially affected groups receive both programs, while many receive only one.

The next practical signals will be state budget requests, agency notices, CMS implementation materials, USDA’s final administrative-cost rule and state-specific payment-error data. For households, the most important question will be how their state defines documentation, exemptions and deadlines—and whether agencies have enough staff and system capacity to process those decisions accurately.

Sources

• CMS/Medicaid.gov community-engagement implementation page
• USDA proposed SNAP administrative-cost rule
• Congressional Research Service comparison of Medicaid and SNAP work rules
• National Governors Association 2026 HHS Policy Advisors Institute

The phased reviews will continue through June 2027. For members whose rules apply, the key questions are whether they completed a qualifying activity, qualify for an exemption or temporary hardship, and can respond if the Nebraska Department of Health and Human Services asks for proof.

Who is affected

The requirements target Medicaid expansion, also called Heritage Health Adult. Generally, that category covers adults ages 19 through 64 who are not pregnant, do not have a disability, are not enrolled in Medicare, meet the expansion income limit and satisfy citizenship or immigration rules.

DHHS says the expansion income limit is up to 138% of the federal poverty level. The rules do not apply to every Nebraska Medicaid recipient. Children, many people receiving Medicaid because of disability or pregnancy, and people in other eligibility categories are outside the expansion group.

When existing members are reviewed

For an existing Medicaid expansion member, DHHS checks compliance as part of the person’s regular renewal. The first members affected are those with eligibility periods ending on or after July 31, 2026. Each member is reviewed in that person’s own renewal month as the state phases in the process through June 2027.

Members with renewal dates in May or June 2026 are not subject to the work requirements during those renewal periods, according to DHHS. Members can check their individual renewal date by logging in to iServe, Nebraska’s online benefits portal.

For existing members, DHHS looks back over the 12 months since the last eligibility determination or renewal. The member generally must have at least one qualifying month during that period, or qualify for an exemption or temporary hardship.

What counts as compliance

A qualifying month generally includes at least 80 hours of one or more approved activities in a calendar month. Those activities include:

• Paid work;
• Volunteering;
• School or an apprenticeship;
• Participation in a work program.

Hours from different activities may be combined to reach 80 hours in one calendar month. Attending school or an apprenticeship at least half time may also satisfy the activity requirement without reaching 80 hours.

DHHS also lists a separate work-earnings route. A member can qualify by earning at least $580 from work in a calendar month. For seasonal workers, DHHS says average monthly work income of at least $580 over the previous six months can qualify regardless of the number of hours worked. The $580 figure is a qualifying-work standard, not a universal Medicaid income rule.

Exemptions and temporary hardships

Major exemptions listed by DHHS include pregnancy and up to 12 months postpartum for people who had Medicaid while pregnant; blindness, disability or other serious medical conditions; caring for a child age 13 or younger or a person with a disability; certain tribal, Urban Indian or Indian Health Service status; foster-care alumni under age 26; qualifying SNAP or TANF circumstances; participation in a qualified drug or alcohol treatment program; and incarceration or release within 90 days of a qualifying month. DHHS also lists a total disability rating for veterans.

Temporary hardships may include hospitalization or a nursing-facility stay, travel by the member or a dependent for serious medical care unavailable in the community, residence in a county under a federal emergency declaration, or residence in a county with a qualifying high unemployment rate. DHHS currently identifies Dawson County residents who meet the stated qualifying-month conditions as eligible for an automatic, temporary high-unemployment hardship.

Documentation differs by category. DHHS says it will check federal emergency declarations and qualifying high-unemployment counties automatically. A declaration form may be required for categories such as hospitalization, nursing-facility stays or medical travel. The agency also says its declaration form can be used for certain volunteer, education or work-program activity, caregiving, previous incarceration, medical exemption and veterans’ disability claims. Members should use the current DHHS instructions for the category that applies to them.

How DHHS verifies compliance

DHHS says it will first use information already available to determine whether a member met the requirement or qualifies for an exemption. If the agency can verify compliance, it will send an approval notice and the member generally will not need to submit additional proof.

If DHHS does not have enough information, it will send a verification notice describing what is needed. Examples may include pay stubs, school records, or proof of volunteer or work-program hours.

Members generally have 30 days from receiving the notice to respond. DHHS warns that failure to provide requested information may result in denial or loss of Medicaid coverage. That does not mean coverage is automatically terminated after 30 days; the consequence depends on the agency’s eligibility decision and the information in the notice.

What Nebraska enrollees should do now

First, check the renewal date in iServe. Do not assume that the May 1 start date means an immediate review for everyone.

Members who may be subject to the rules should preserve records showing work, volunteer hours, school, apprenticeship, work-program participation or qualifying earnings. They should also report changes that may affect eligibility, including changes in income, address, work status, household size, marriage, divorce, pregnancy or adoption.

Watch mail, email and text messages for a DHHS verification notice. If the agency requests information, members can respond through iServe, by mail, by phone or at a local DHHS office. DHHS lists the statewide number as (855) 632-7633, with option 3 for Medicaid-related assistance. The agency also lists Lincoln, Omaha and TTY numbers on its work-requirements page.

Anyone whose coverage is at risk should contact DHHS promptly and ask whether an exemption, temporary hardship, renewal issue or appeal option applies.

What remains uncertain

Nebraska has published its verification process and phased schedule, but statewide coverage-loss outcomes from the new rules are not yet established. Nebraska Public Media reported that DHHS expects many members to qualify based on information already available, while advocates warned that paperwork, notices and administrative delays could cause eligible people to lose coverage.

Those concerns are not the same as confirmed statewide results. For members, the immediate practical steps are to check the renewal date in iServe, keep contact information current, preserve qualifying-activity records, review possible exemptions and respond within 30 days if DHHS requests proof.

Sources

• Nebraska DHHS Work Requirements
• Nebraska Public Media implementation report

The Arkansas Department of Human Services began the checks on July 1 for many adults enrolled in Arkansas Health and Opportunity for Me, or ARHOME. DHS says the six-month period is being used to test verification systems and notify beneficiaries before penalties begin on January 1, 2027.

The change principally affects nonpregnant ARHOME adults ages 19 through 64 who are not otherwise exempt. It does not apply to every Arkansas Medicaid beneficiary.

What DHS is checking

Beginning January 1, 2027, people subject to the requirement generally must demonstrate 80 hours per month of qualifying activity. The hours can come from paid work, community service, qualifying work programming, qualifying education or a combination of those activities.

Under the federal rule, an individual may also meet the standard through qualifying monthly income. The Centers for Medicare & Medicaid Services says the 2026 income threshold is at least 80 times the federal minimum wage, or $580 per month, with a different calculation for seasonal workers.

During the soft implementation, DHS may compare Medicaid records with wage information, Supplemental Nutrition Assistance Program and Transitional Employment Assistance records, medical claims, diagnosis information and other available data. The goal is to determine whether the agency can verify a person’s status without requiring every beneficiary to submit documents immediately.

A notice now does not mean coverage is ending

Beneficiaries may receive notices explaining whether state records verify that they are meeting the upcoming standard. A notice saying DHS could not verify compliance is not the same as a final finding that a person is ineligible or has failed the requirement.

DHS says no penalties under the new requirement will be imposed during the 2026 soft implementation. Residents who continue to meet existing Medicaid eligibility rules will not lose coverage solely because the new requirement could not be verified during this period.

Arkansas Advocate reported that DHS is using the six-month period to test automated checks and give beneficiaries an early indication of what state records show. The agency has said the notices will explain that the requirement does not take effect until January 1, 2027, even if the state cannot verify a beneficiary’s status during the soft implementation.

Who may be exempt

Federal rules exempt or otherwise protect some categories of people, including pregnant or postpartum individuals, people who are medically frail or have special medical needs, certain caregivers, some veterans, American Indians and Alaska Natives, people in qualifying treatment programs and people in certain other Medicaid eligibility groups.

The list is not a guarantee that an exemption will be recognized automatically. If DHS cannot verify a person’s status through its records, the beneficiary may need to provide information showing that an exemption or exception applies.

CMS says states must give people an opportunity to demonstrate compliance or establish that the requirement does not apply to them when automated records are insufficient. States may also provide certain short-term hardship exceptions under the federal rule.

What changes on January 1, 2027

Once the requirement is in effect, people subject to the rule whose compliance cannot be verified generally will receive a notice and have 30 calendar days to provide information showing that they met the requirement or qualify for an exemption or exception.

If a person does not respond successfully, coverage may be suspended or an application may be denied under applicable Medicaid procedures. CMS says people disenrolled for failure to meet the requirement may reapply, but their compliance will be assessed again.

What ARHOME beneficiaries should do now

DHS advises ARHOME beneficiaries to update their contact information and sign up for text and email alerts through Access Arkansas. Residents can update their information online, call the Access Arkansas hotline at 1-855-372-1084 or visit a DHS county office.

Beneficiaries should keep records that may show qualifying work, education, community service or participation in an approved work program. People who believe they are exempt should review the applicable rules and be prepared to provide supporting information if the state’s records do not identify their status.

The immediate deadline is not a penalty date. The practical step now is to make sure DHS can reach you and that you understand any notice before the new enforcement period begins on January 1, 2027.

Sources

• Arkansas DHS: ARHOME Community Engagement and Work Requirement
• CMS: Medicaid Community Engagement Requirement Fact Sheet
• Arkansas Advocate: Arkansas has begun a soft launch of Medicaid work requirements

The requirement does not apply to every Ohio Medicaid enrollee. It is aimed primarily at adults in the expansion group, known as Group VIII, generally ages 19 through 64, with household income up to 138% of the federal poverty level who do not qualify for an exclusion.

Ohio Medicaid’s implementation plan calls for required outreach to Group VIII enrollees by September 2026. Federal guidance also requires states to conduct outreach about compliance, exclusions, consequences and reporting before implementation. The outreach and system work are preparation steps; they do not move Ohio’s effective date before January 1, 2027.

What changes on January 1, 2027

Under the federal framework, an enrollee subject to the requirement generally must complete 80 hours each month in one or more qualifying activities. Those activities include paid employment, community or volunteer service, job training and education.

People may combine activities to reach the monthly total. CMS’s Ohio guidance says employment may also be measured through earnings and lists $580 per month as an example threshold. School hours may count, and people enrolled at least half-time, as defined by their school, will likely meet the requirement under the federal guidance. Ohio’s final procedures may provide additional instructions.

The rule applies to people who are enrolled in or applying for Medicaid expansion coverage, sometimes called Group VIII. It is separate from Ohio’s earlier proposed waiver framework under House Bill 33, which sought different eligibility limitations. Ohio’s current implementation materials address the federal community-engagement requirement created by the 2025 federal law, not an automatic adoption of every provision in the earlier state proposal.

Who is most likely to be affected

CMS describes the potentially affected population as adults ages 19 through 64 with household income up to 138% of the federal poverty level who do not qualify for an exclusion. CMS’s Ohio guidance lists approximate annual income levels of $22,025 for one person and $29,863 for two people.

Ohio’s February 2026 presentation estimated that 774,342 people were in Group VIII in a July 2025 eligibility snapshot. The presentation estimated that 172,460 members would require further assessment. Those figures describe an earlier population snapshot and do not predict how many people will lose coverage.

Ohio’s timeline and renewal process

January 1, 2027 is the effective date of the community-engagement requirement. Earlier system updates, outreach and communications are implementation milestones, not an earlier start date.

Ohio says people who apply on or after the implementation date will be reviewed under the new rules. Existing Group VIII enrollees will generally be evaluated at their next eligibility renewal. Ohio’s presentation says the process will follow the regular eligibility-renewal steps and identifies six-month redeterminations as taking effect January 1, 2027.

Ohio plans to use existing state and federal data where possible. Its implementation materials identify wage, unemployment, Social Security, Medicare, veterans, new-hire and incarceration data among the sources used in eligibility administration. Federal rules require states to check reliable information available to them before requesting additional information from a resident.

If available data cannot verify compliance or an exclusion, Ohio may request records or other information. If the state cannot verify that a person meets the rule, federal procedures require a notice of noncompliance and a 30-calendar-day opportunity to respond. The period begins when the notice is received; the federal correction generally treats the notice as received five days after its date unless the person shows it was not received within that period.

Common exclusions

The federal framework includes exclusions for people who are not subject to the 80-hour standard. CMS lists examples including:

• Current pregnancy or giving birth within the previous 12 months;
• Being a parent, guardian, caretaker relative or family caregiver for a child under 14 or a person with a disability;
• Blindness or a physical, intellectual or developmental disability;
• A functional limitation that makes daily activities difficult;
• A substance-use disorder or serious mental-health condition, including participation in treatment or recovery;
• Current or former foster-care status before age 26;
• Membership in an Indian or Urban Indian tribe;
• Medicare eligibility;
• Certain veteran categories, including a veteran with a total disability rating from the Department of Veterans Affairs;
• Current incarceration or release from a correctional facility within the previous three months; and
• Already meeting applicable SNAP or TANF work requirements.

An exclusion is different from proving 80 hours of monthly activity. A person who qualifies for an exclusion generally must show why the exclusion applies rather than document work or school hours. Ohio and federal officials may use electronic records, but residents may still be asked for supporting information when available data does not establish eligibility.

The medically frail question remains unsettled

Medical frailty is one of the most consequential unresolved implementation issues. The Federal Register correction says states must try to verify medical frailty or special medical needs using reliable information, including relevant adjudicated claims and encounter data from the preceding 12 months.

Before January 1, 2028, when reliable information is unavailable or inconsistent with information provided by the enrollee, the federal correction allows a state to require documentation or accept a statement or other information under penalty of perjury, as determined by the state. The rule also calls for at least annual reverification after medical-frailty status is verified.

That does not mean Ohio’s final process is settled. The federal rule was issued with a comment period, and Ohio reporting indicates that the definition and documentation treatment for medically frail residents remain subject to further federal guidance and state implementation decisions. Residents should not assume that a particular doctor’s note or other document will automatically be accepted by Ohio.

What Ohio Medicaid enrollees should do now

Residents who may be affected should update their address, phone number and email with Ohio Medicaid, check mail and electronic notices, and respond promptly to renewal requests.

It is also prudent to keep a monthly record of work, school, training and community-service hours. People who may qualify for an exclusion should gather relevant medical, caregiving, pregnancy, tribal, foster-care, veteran or correctional records and ask Ohio Medicaid how those circumstances should be reported.

Failure to verify compliance could lead to a notice, a 30-day response period and possible loss of coverage. Ohio Medicaid’s presentation estimates that about 62,000 enrollees could lose Medicaid eligibility during state fiscal years 2026-27. That is a projection, not a confirmed outcome.

Sources

• Ohio Medicaid Work & Community Engagement Requirements presentation
• CMS Ohio Medicaid eligibility changes and community-engagement guidance
• CMS nationwide framework for Medicaid work requirements
• Federal Register correction to CMS-2454-IFC
• Signal Ohio: What to know about Medicaid work requirements coming to Ohio

The change will not apply to every Granite Advantage member. According to Concord Monitor reporting based on state information, 47,571 residents were expected to encounter the new rules at their first Medicaid redetermination in 2027. That is an estimate of the population expected to be subject to the rules, not a prediction of how many people will lose coverage.

What changes on January 1, 2027

Federal law requires states, beginning January 1, 2027, to condition Medicaid eligibility for applicable individuals on demonstrating community engagement unless a state starts sooner. New Hampshire’s current implementation information uses the January 1 start date, according to the Centers for Medicare & Medicaid Services.

If the requirement applies, a member generally must complete at least 80 hours per month in one or more qualifying activities. The CMS New Hampshire guidance lists paid work, volunteer or community service, certain job-training programs and qualifying education. School attendance can count; people who work may also qualify through monthly earnings of at least $580. Different activities may be combined to reach the monthly standard.

The requirement is considered during Medicaid eligibility reviews. If it applies and a member does not demonstrate compliance or an exclusion, the state may end coverage or deny an application. Coverage loss is not automatic for every Granite Advantage member who falls short, and New Hampshire is still developing parts of the reporting and review process.

Who may be affected

The general affected group is adults ages 19 through 64 with household income up to 138% of the federal poverty level who receive coverage through the applicable Medicaid adult expansion category and do not qualify for an exclusion. CMS lists approximate annual income figures of $22,025 for a one-person household and $29,863 for a two-person household on its New Hampshire-specific page.

The timing will depend on each member’s first 2027 redetermination. Members should not assume that every person enrolled in Granite Advantage will face the same deadline or the same requirements.

Exclusions can change the result

CMS lists circumstances that may exclude a person from the community-engagement requirement. They include:

• Being under age 19 or age 65 or older;
• Being pregnant or having given birth within the previous 12 months;
• Being a parent, guardian, caretaker relative or family caregiver for a child under 14 or a person with a disability;
• Being released from a correctional facility within the previous three months;
• Being a veteran with a total disability rating from the Department of Veterans Affairs;
• Being a member of an Indian or Urban Indian Tribe;
• Being a current or former foster youth under age 26;
• Already meeting work requirements for SNAP or TANF;
• Having a functional limitation that makes daily activities difficult;
• Being blind or having a physical, intellectual or developmental disability;
• Having a substance-use disorder or serious mental-health condition;
• Participating in a substance-use treatment or recovery program; or
• Having or qualifying for Medicare Part A or Part B.

The state has not finalized every exemption standard, reporting method or operational procedure. The Concord Monitor reported that New Hampshire was awaiting additional federal guidance on who qualifies and how members will report work or community-engagement activities. CMS also says it anticipates further guidance as states implement the policy.

What New Hampshire is doing now

New Hampshire’s Department of Health and Human Services has begun an early-engagement campaign. CMS says Granite Advantage members should expect a letter or email in the coming months if the changes may apply to them.

State officials are also sharing information with Medicaid providers, community organizations and other groups. The immediate goal is to give members time to determine whether the requirement may apply, whether an exclusion may apply and what records they may need to provide.

Renewals will also become more frequent

A separate federal change requires six-month eligibility renewals for most people in the Medicaid adult expansion group beginning with renewals scheduled on or after January 1, 2027. The rule applies to members of that expansion group whether or not they are subject to the community-engagement requirement, according to CMS State Medicaid Director Letter SMD 26-001.

The two changes are related but distinct. The six-month rule changes how often eligibility is reviewed. The community-engagement rule adds an activity or exclusion determination for people to whom it applies.

CMS says states must generally begin a renewal by checking reliable information already available to them. If that information is not enough, the state must send a renewal form and give the beneficiary at least 30 days to return the form and requested information. Before termination or another adverse action, states must provide advance notice and fair-hearing rights under federal rules.

Steps Granite Advantage members can take

Members who may be affected should update their address, telephone number and email address with New Hampshire Medicaid. They should monitor both physical mail and electronic messages for state notices.

Keeping a monthly record of work, school, training and volunteer hours can help document qualifying activity. People who believe an exclusion applies should begin gathering relevant medical, legal, school, military, tribal or other supporting records.

Members should also pay attention to the date of their first 2027 redetermination. The timing will differ by person, and not every Granite Advantage member will face identical requirements.

If coverage ends or an application is denied, CMS says a person may apply for Medicaid again. Depending on the circumstances, the person may also qualify for coverage through the federal Health Insurance Marketplace, although financial assistance may not be available in every case.

Sources

• CMS: Granite Advantage Health Care Program Eligibility Changes
• Concord Monitor: Work requirements coming for people on Medicaid Granite Advantage

The Kentucky Department for Medicaid Services began mailing the outreach notices on July 1, 2026. The state may also use text messages or email. Additional notices are planned before affected members reach their 2027 renewal dates.

What changes in 2027

Beginning Jan. 1, 2027, some adults ages 19 to 64 will need to meet a work or community-engagement requirement to apply for or keep Medicaid coverage. The requirement applies to people who qualify for Medicaid based only on income through Medicaid expansion and who are not exempt.

People applying for Medicaid on or after Jan. 1, 2027, who are subject to the rule must show that they met the requirement in the month before applying. Current members will report their activity when they renew coverage in 2027.

For current members, Kentucky’s guidance says they must show qualifying activity for at least three of the six months before the renewal date. The months do not have to be consecutive. For example, a person with a February 2027 renewal would generally document activity in at least three months between August 2026 and February 2027.

The rule does not automatically apply to every adult ages 19 through 64 or to every person enrolled in Medicaid. Traditional Medicaid members are not subject to this particular requirement.

Activities that can count

State guidance lists work, job training, work programs, volunteering, community service and qualifying education among the activities that may satisfy the standard. Members may combine qualifying activities to reach 80 hours per month.

Going to school at least half-time may also satisfy the requirement. Kentucky’s enrollment guidance also lists earning $580 per month, or an average of $580 over the previous six months for seasonal work, as another way to meet the standard.

Members should keep records of hours, wages, school enrollment, training participation or volunteer service. Kentucky says it will check available information and contact members if more information is needed.

Who may be exempt

Kentucky lists exemptions for several groups, including parents, guardians or caregivers actively caring for a child age 13 or younger or a person with a disability; people with disabilities or serious or complex medical conditions; pregnant or postpartum people; certain veterans; Medicare recipients; former foster-care youth under age 26; members of federally recognized tribes; and people receiving disability-related SSI, SSDI or Social Security retirement benefits.

Other listed exemptions include people enrolled in certain home- and community-based waiver programs or PACE, people in qualifying mental-health or substance-use treatment programs, people meeting certain TANF or SNAP work requirements, and some people who are incarcerated or were recently incarcerated.

Kentucky says it must be able to document an exemption. Members who believe an exemption may apply should gather medical, disability, caregiver, veteran, pregnancy, Medicare or other supporting records before renewal.

What the first notice means

The sample outreach notice says no action is required immediately. It is informational and is not a termination notice or a notice that the member has failed to meet the community-engagement requirement.

The July 1, 2026, mailing date is separate from the Jan. 1, 2027, start date for affected applicants and from the renewal process current members will face during 2027. Kentucky Medicaid says affected current members will receive additional notices beginning 120 days before their annual renewal.

The Kentucky Health Benefit Exchange guidance says members will be told whether the requirement applies to them and whether the state has identified an exemption. The state also says members can provide more information if they disagree with the determination.

What happens after a noncompliance notice

A member who later receives a noncompliance notice will have 30 days to provide information, report qualifying activity or claim an exemption. For current members, coverage continues during that response period.

If a member does not respond or otherwise fails to meet eligibility requirements, the application may be denied or coverage may be lost. That decision would come through a later eligibility process, not through the initial July outreach letter. Members have the right to appeal an eligibility decision, with instructions included in the Notice of Eligibility.

What members should do now

• Check the renewal date in kynect benefits or in state notices.
• Update mailing addresses, phone numbers and email addresses with Kentucky Medicaid.
• Begin tracking work, education, training, volunteer or community-service hours.
• Keep wage records and other proof of qualifying activity.
• Gather documentation for any exemption that may apply.
• Watch for additional notices by mail, email or text before the 2027 renewal.

Free help is available through kynect, Department for Community Based Services offices and kynectors. Members can call kynect at 1-855-459-6328, call DCBS at 1-855-306-8959, or use the state’s kynector search tools. Anyone who receives a later noncompliance notice should follow its instructions and seek help before the 30-day deadline.

Sources

• Kentucky Medicaid Member Information
• Kentucky Health Benefit Exchange: Changes Coming to Medicaid and Marketplace Coverage
• Kentucky House Bill 2 Legislative Record

Beginning in October, noncompliance may lead to denial of coverage or disenrollment after DPHHS reviews the case and sends an official notice. The requirement is based on federal changes in H.R. 1, which DPHHS identifies as the source of the new Medicaid Expansion rules. It does not apply to every Montana Medicaid enrollee.

Who must meet the 80-hour requirement

The requirement generally applies to non-excluded adults ages 19 through 64 enrolled through Montana Medicaid Expansion. Those enrollees must complete at least 80 hours each month of approved activities unless they qualify for a specified exclusion or a documented short-term hardship.

Qualifying activities include paid employment, community service or volunteering with a nonprofit organization, approved state or federal workforce training or job-readiness programs, and school. Activities may be combined, such as 60 hours of work and 20 hours of volunteer service, according to Montana DPHHS guidance.

For new applicants, DPHHS says the requirement applies to Medicaid Expansion applications filed on or after July 1. Existing enrollees generally first demonstrate compliance at their next scheduled redetermination. DPHHS says cases with an August 31, 2026, redetermination date are the first existing cases expected to be reviewed under the new requirement.

July through September is a hold-harmless period

During July, August and September 2026, DPHHS is reviewing compliance with the community-engagement requirement. The department says applicants and existing members will not be denied coverage or disenrolled solely for noncompliance during those months if they meet all other eligibility conditions.

That protection ends in October. The DPHHS Medicaid Changes FAQ says noncompliance will then be enforced through denial and disenrollment. The action is not described as automatic: DPHHS will review applications and redeterminations, and an adverse decision should be communicated through a Notice of Adverse Action.

The hold-harmless period also gives DPHHS time to evaluate its systems and processing procedures. Montana Public Radio and Montana Free Press have reported concerns from providers, advocates and lawmakers about implementation readiness and how exemptions will be identified and processed. Those reports describe concerns about the rollout, not an established statewide system failure.

Specified exclusions are different from short-term hardships

Montana distinguishes between specified exclusions, which remove the requirement when a person meets the applicable criteria, and exceptions or short-term hardships, which count only for the months they are documented.

DPHHS lists specified exclusions for American Indian and Alaska Native people; children ages 18 or younger; certain former foster youth under age 26; people incarcerated in a public institution; people with a medical condition or health needs that affect their ability to work or perform other qualifying activities; parents, guardians, caretaker relatives or family caregivers of a dependent child under age 14 or a disabled person; people in qualifying drug or alcohol treatment programs; people who meet TANF work requirements or are subject to SNAP work requirements; pregnant or postpartum women for up to 12 months; and veterans with a total, 100% disability rating.

A medical diagnosis alone does not automatically establish an exclusion. DPHHS’s medically frail framework covers specified categories of conditions that significantly impair a person’s ability to comply, and the department accepts provider documentation or an allowed self-declaration process. DPHHS says it expects additional guidance and clarification from the Centers for Medicare and Medicaid Services and may update its approach.

Short-term hardships may include inpatient care, living in a county covered by an emergency disaster declaration, or travel outside the community by the enrollee or a dependent for serious or complex medical care. Montana says it is not implementing the high-unemployment exception at this time. The FAQ also lists Medicare eligibility and recent incarceration among exceptions that may satisfy the requirement for applicable months.

At application, DPHHS generally looks at the month before the application. At redetermination, the agency generally looks at at least three months since the prior redetermination, and the months do not have to be consecutive. If an exception or hardship applies for only one or two months, the enrollee generally must document qualifying activity for the remaining months.

What documentation to keep

DPHHS says enrollees should retain records that match the activity or exclusion they report. Examples include pay stubs, school schedules or transcripts, signed volunteer logs, workforce-training forms, provider records, facility documentation, veteran records and program records.

The department’s Verification Matrix lists documentation for different categories. For example, employment may be reported through the Medicaid community-engagement reporting form with supporting verification such as pay stubs; community service may require a signed service or verification form; workforce training may require a Labor and Industry participation form; and education may require a school schedule or transcript.

Some self-declarations are accepted only in specified circumstances. DPHHS says information submitted through self-declaration may later be checked through available data or other verification methods.

What Montana enrollees should do now

• Confirm whether your coverage is through Medicaid Expansion and whether you are ages 19 through 64.
• Review whether a specified exclusion or short-term hardship applies to you.
• If no exclusion applies, track 80 hours of qualifying activity for each month and save supporting records.
• Report medical conditions, caregiving responsibilities and other possible exclusions through the process described by DPHHS.
• Keep your mailing address, phone number and email current in the Medicaid Self-Service Portal.
• Read every DPHHS notice carefully.
• If DPHHS takes an adverse action, follow the appeal instructions in the Notice of Adverse Action and meet the deadline stated in that notice.

The July-through-September hold-harmless period provides time to organize records and report exclusions. It does not eliminate the need to prepare for possible enforcement beginning in October 2026.

Sources

• Montana DPHHS, Changes to Medicaid
• Montana DPHHS, Medicaid Changes FAQ
• Montana Public Radio, Groups take to the state Capitol to rally against Medicaid rule changes

The change is a federal Medicaid requirement that Idaho is preparing to implement, not a new Idaho statute. It will apply to the state’s Medicaid expansion population, with exemptions and temporary hardship provisions for people who meet specified conditions.

What the new standard requires

In general, people must document at least 80 hours per month of qualifying activity. Idaho lists employment, education, job training, work programs, volunteer service, community service or a combination of those activities.

People who earn at least $580 per month can meet the requirement through the earnings alternative instead. The $580 threshold is separate from the 80-hour activity standard; residents do not need to satisfy both when the earnings alternative applies.

Applicants face a three-month look-back

Beginning January 1, 2027, people applying for Idaho Medicaid expansion generally must show that they met the activity or earnings standard, or qualified for an exemption, in each of the three consecutive months before applying.

The three-month look-back applies to applicants. It is different from the review process for people who are already enrolled.

Current enrollees will be reviewed on six-month cycles

Existing Medicaid expansion enrollees will be reviewed according to six-month coverage and renewal cycles. Idaho says the first checks will apply to coverage periods ending on or after January 1, 2027. That does not mean every enrollee will be reviewed on January 1; timing will vary by the person’s coverage period and renewal schedule.

For current enrollees, qualifying activity, an exemption or a temporary hardship must apply during at least three calendar months in the six-month review period.

Activities that may count

Idaho lists several types of qualifying activity, including:

• Paid employment or participation in a work program
• Volunteer or community service
• Job training
• College or technical education
• High school or GED programs
• A combination of qualifying activities

Residents may want to keep records of hours, participation and earnings in case the department requests information.

Exemptions cover several circumstances

The requirement does not apply in the same way to everyone. Idaho’s guidance lists exemptions for people who are pregnant or were pregnant within the previous 12 months; parents or other relatives who are the main caregivers of a child age 13 or younger; caregivers of a person with a disability; and people with physical, mental or developmental disabilities that make daily activities difficult.

Other listed categories include people with serious or complex health conditions requiring regular medical care, substance-use disorders or participation in drug or alcohol treatment, disabling mental health conditions, blindness, and people ages 18 to 25 who aged out of foster care.

Idaho also lists American Indian and Alaska Native people, veterans with a 100% disability rating, people who are currently incarcerated or were released within the previous 90 days, and people already meeting SNAP or TANF work requirements.

Residents who believe an exemption may apply should review the category and be prepared to provide information if the department does not already have the necessary documentation.

Temporary hardships may also apply

Idaho identifies limited temporary hardship circumstances that can pause activity reporting for a short period. Examples include a hospital stay, travel for medical care and a natural disaster.

A temporary hardship is not the same as a permanent exemption. Residents should follow DHW instructions about the applicable period and any information needed to document the hardship.

What Idaho residents should do now

DHW says it is sending letters to affected households and plans additional communications, including virtual town halls, before implementation. Residents can take several steps now:

• Update mailing address, phone and email information through Idalink.
• Sign up for email and text alerts and monitor mailed notices.
• Track work, school, training, volunteer and community-service activity.
• Review whether a health, caregiving, tribal, veteran, foster-care, incarceration or SNAP/TANF exemption may apply.
• Respond promptly if DHW requests records or other information.

For questions, to verify enrollment status or to provide requested information, DHW lists 877-456-1233, Idalink and MyBenefits@dhw.idaho.gov.

What happens next

Idaho will continue notifying Medicaid expansion participants before the January 1, 2027, implementation date. Current enrollees will not all face review at once; their timing will depend on the end of their six-month coverage period and renewal cycle.

For applicants, the key preparation issue is documenting the three months before an application. For current enrollees, the practical step is to maintain records throughout each six-month review period and respond when DHW asks for information.

Sources

• Idaho Medicaid expansion requirements
• CMS launches nationwide framework to implement Medicaid work requirements
• Idaho Medicaid expansion recipients will face new work reporting requirements beginning in 2027

DHS says the change is meant to restore broader discretion for immigration officers to make individualized, fact-specific determinations under a totality of the circumstances framework—rather than relying on the narrower structure used under the 2022 rule.

Background: what “public charge” is

In immigration law, DHS/USCIS can deny certain admission or adjustment requests if an applicant is found likely at any time to become a public charge. Over time, regulations have explained what evidence officers may consider and how those decisions are supposed to work.

Under the 2022 regulations, the process was narrowed—especially in how certain public benefits could be counted in the analysis.

What DHS rescinded—and what it replaced

In the July 20, 2026 final rule, DHS rescinds the 2022 public charge ground-of-inadmissibility regulatory framework and replaces it with a new structure DHS describes as centered on officer discretion and an individualized, totality-of-the-circumstances assessment.

DHS also amends related provisions tied to public charge bond rules, updating the regulatory approach to match the shift in the underlying public charge determination framework.

Key timing: publication date vs. when the rule applies

Two dates matter—publication and effectiveness.

• Publication date: July 20, 2026.
• Effective date: September 18, 2026.

DHS states the rule applies to admission applications made on or after September 18, 2026 and adjustment of status applications that are postmarked or electronically submitted on or after September 18, 2026.

It also draws a line for benefits timing: receipt of means-tested public benefits before September 18, 2026 will be considered consistently with the 2022 final rule.

How means-tested public benefits may factor in (including health programs)

DHS’s stated practical change is how means-tested public benefits enter the officer’s overall assessment. In the Federal Register, DHS emphasizes that officers will have discretion to consider the relevance of means-tested public benefits within the totality of the circumstances—and that benefits are not treated as automatically deciding outcomes by themselves.

Importantly for many readers, DHS discusses health coverage programs directly. For example, DHS states it is not excluding consideration of means-tested public benefits from the analysis, including Medicaid and CHIP, and says officers will weigh them based on the facts of a specific case.

That means families may want to review their timelines now—especially if they’re deciding when to file, whether benefits were received before or on/after September 18, 2026, and what evidence they plan to submit for the officer’s overall assessment.

Bond changes: what DHS says will happen

The rule also revises public charge bond-related provisions. DHS explains it is updating bond regulations and says the government is “held harmless” if a bonded alien breaches a public charge bond as required by the statute.

DHS also clarifies that aliens who submitted a public charge bond before the effective date are held to the regulatory standards reflected in the 2022 framework and the bond form that was accepted at the time.

What to watch next before September 18

As the effective date approaches, DHS describes USCIS actions intended to support consistent implementation—such as subregulatory guidance and officer training. For readers preparing filings around this deadline, the key practical next step is to keep September 18, 2026 on your timeline and monitor for USCIS guidance that may affect how officers evaluate evidence.

Sources

• Federal Register public inspection PDF: DHS Final Rule, “Public Charge Ground of Inadmissibility” (2026-14539)
• Federal Register document page: “Public Charge Ground of Inadmissibility” (2026-14539)
• Associated Press: “DHS revives public charge rule framework for green cards” (July 21, 2026)
• Axios: “Trump 'public charge' rule resets health test for green cards” (July 21, 2026)