Survey Finds Nearly Half of Medicaid Members Are Unprepared for 2027 Work Requirements

ASHEVILLE, North Carolina—With new Medicaid community work requirements taking effect nationwide for certain individuals starting Jan. 1, 2027, a new survey of more than 1,000 Medicaid members suggests that awareness alone may not be enough to protect continuity of coverage.

Aeroflow Health, a medical products and services healthcare company, surveyed 1,225 Medicaid members in August 2026 to assess their awareness of and readiness for the forthcoming Medicaid work requirements, the communication they have received and their primary concerns about implementation. The findings point to a critical gap between awareness and readiness. Affected members will need clear, state-specific guidance on what information is required and how and when to submit it, Aeroflow said.

Some states may choose to implement the requirements sooner. Certain individuals will need to demonstrate their participation in “qualifying activities,” such as employment, community service or work programs, to enroll in or maintain Medicaid coverage. However, numerous populations are exempt, making clear, individualized communication paramount.

Findings

Nearly two-thirds (63%) of respondents were aware of the upcoming work requirements. However, 44% said they were not prepared to submit the required documentation.

The findings suggest that limited communication may create confusion about whether the requirements apply and what steps members need to take to maintain coverage. Nearly half of respondents (46%) reported receiving no reminders about the work requirements; 42% said they had only received between one and three reminders. Respondents identified Medicaid as the source they trust most to provide information about the requirements, citing text messages, emails and phone calls as the most helpful methods for receiving reminders.

“People should not lose Medicaid coverage because the reporting process was confusing, especially when they have met the requirements or qualify for an exemption,” said Casey Hite, chief executive officer of Aeroflow Health. “That is the risk our findings expose. Awareness is not readiness. Members need to know whether the rules apply to them, what information is required and exactly how and when to submit it. One general notice will not be enough.”

The survey results highlighted major uncertainties around how this policy will apply to individual members, with a third (33%) of respondents citing their leading concern as determining whether or not they qualify under the new requirements. Beyond that, more than half of respondents (53%) said they had delayed or changed healthcare because of coverage concerns, while 89% said losing Medicaid coverage would affect their ability to obtain care or supplies.

“At Aeroflow, we see every day how coverage disruptions affect whether patients can get the care and supplies they need,” said Hite. “We also know members respond when information is timely, specific and delivered through channels they trust. That is where we can help. Working with health plans, we can use plan-approved information to coordinate clear, state-specific outreach and reminders before members’ coverage is at risk.”

Aeroflow Health urges state Medicaid programs and health plans to bolster member education ahead of the Jan. 1, 2027, implementation date by:

• Clearly explaining which members are subject to the requirements and which may qualify for exemption
• Providing clear instructions for documenting and reporting “qualifying activities”
• Sending multiple reminders through the member’s preferred channels (text, email and phone)
• Making assistance readily available for members with questions
• Ensuring that all communications use straightforward language that clearly illustrates the actions members must take

Read the full survey results here.