Medicaid Work Requirements and Frontline Burden at a Safety Net Hospital

The One Big Beautiful Bill Act (OBBBA) requires states that expanded Medicaid to low-income adults to implement work requirements for this population. The need to demonstrate compliance with—or exemption from—these new work requirements will impose new documentation burdens for enrollees and those who help enrollees navigate enrollment processes. Health care systems that serve large Medicaid populations and employ counselors to assist with Medicaid enrollment and recertification will see an increase in workload as they adjust to these new rules. This project aims to characterize and address the burden of these staff as work requirements roll out at Cambridge Health Alliance, a safety-net hospital system serving the Greater Boston area, in service of developing an effective intervention to minimize burdens in the future. This grant supports a convening of patients, staff, and leadership at Cambridge Health Alliance.