Dozens of tech companies are offering the federal government sweet, sweet discounts to bring more AI to your Medicaid benefits, but not very many people are talking about what’s going on and what this means for you as someone who relies on Medicaid.
So today, we’re going to dive into why these changes are being made, what companies are trying to get involved in your Medicaid coverage, what that involvement might look like, what they’re going to do, and so on, so that you have all the information you need to be prepared.
This is a transcript of our video. You can watch the full video on our YouTube channel: Low Income Relief.
Why This Is Happening
First, I want to talk a little bit about why this is happening.
As you probably know, last year Congress passed some pretty big bills that made huge changes to Medicaid, including adding those new community engagement requirements. They call it community engagement. The rest of us pretty much call it what it is, which is work requirements. They’re going to be forcing more people to work in order to keep those benefits.
Once these community engagement requirements go into effect, you’ll have to log 80 hours a month in order to continue those benefits. Those hours can be achieved through work, attending school, volunteering in the community, participating in job training programs, or mixing and matching any of those things. They want you doing that for about 20 hours a week, or 80 hours a month, going forward.
Those changes are supposed to go into effect on January 1st, 2027, or earlier. Some states are rolling this out before that deadline, but a lot of states are taking this time during 2026 to gear up and prepare their systems to manage these new work requirements because that’s a lot more paperwork than they’ve been doing.
So, enter your friendly neighborhood tech company.
Together, these companies have pledged over $600 million in tech help to the government to make this easier. This money is coming in the form of free or discounted software to help states build more tracking systems.
I know with the rollout of AI, I’ve heard from a lot of you who are concerned about this. So I wanted to make sure we were upfront and open about what this might mean.
As of right now, there are over 18 companies involved. Some of them are pretty major vendors. There are some names in here you’re going to recognize. The money being used here is going toward upgrading state computer systems. None of this funding is going to go directly to those of you who get Medicaid. I just want to be really clear on that point.
If you’re wondering why all of these tech companies are getting involved, it’s not necessarily out of the goodness of their hearts. I looked over a lot of the details, and many of them are giving states a discount so that it’s “just” $2 million, which is still a pretty sizable contract. There’s a lot in it for the tech companies as well.
Which Companies Are Involved
We showed a list of the different companies that have made pledges so far, and you can see some pretty common names like Deloitte, Equifax, and Experian. Those are your credit bureaus. Then you’ve got Google, TransUnion, ID.me, and lots of other big names as well.
These are the ones that have made pledges. States are not necessarily required to use any specific company as a result of this, but other companies are still trying to edge in on this as well. Some that are currently on an expedited path to try to get involved include names like Fortuna Health, Optum, and FindHelp.
If you’re wondering what these companies plan to do exactly with the government, that information is pretty open on the CMS website. A fact sheet was published at the end of January. It lists the vendors and breaks it down by company to explain what they have in mind.
You’ll see a lot of talk about automation and advanced technologies, basically things that sound a lot like AI tracking Medicaid users. Some companies are highlighting tools that can help support fraud, waste, and abuse detection. That’s something the government has really been focused on.
For example, one listing says licensing will be provided at no cost to each state through 2028. After 2028, I’m sure that price is going to go up, which will likely reward companies like Accentra Health for helping states get started with this. So like I said, there’s definitely something in it for these tech companies as well.
You’ll also see things like AI-driven fraud tools delivered at cost to states, discounted one-time implementation costs of $2 million per state, core technology changes, service credits, and verification hubs that can access multiple data sources. Some offer no-cost installation in year one. Others are offering outreach platforms and additional tools.
One thing that might be relevant to some of you is that Gainwell is talking about medical frailty logic. That’s something they’re looking to verify as well.
If you’re interested in all of these details, they’re pretty clearly laid out on the cms.gov website if you’d like to read through it yourself.
How This Could Affect Your Data
As you can see in that documentation, a lot of this comes down to your data being cross-checked automatically. That may include things like employment records, credit bureaus, and identity platforms like ID.me. They’re going to be looking to verify employment and also looking for waste, fraud, and abuse—any mismatches in what you’re telling them versus what other records show.
That can be especially impactful if they’re drawing automatically from credit bureaus. A lot of this comes down to using AI and automated tools to fact-check and cross-check your data.
They may compare what you’re telling the Medicaid office to what your employment records show, or what you’ve told lenders when applying for loans, which can end up reflected in credit bureau data. That information could be used for cross-checking going forward.
Some of the data they may cross-check includes whether you’re really enrolled in school, whether you’re really working that many hours, whether you’re reporting the same amount of income everywhere, and whether you’re participating in SNAP as well as Medicaid.
It was pretty clear that AI will be used to flag applications. That’s my interpretation of all the “waste, fraud, and abuse” language. It sounds like they will be using a lot of automation and AI to make that possible.
This means that going forward, your state may use a computer, not a person, to flag cases for review.
The data sharing is supposed to be consent-based, based on what I read. However, in many benefit programs, you consent when you sign your application or other paperwork, and you may not realize that you’re giving them permission to cross-check your data with automated systems.
I am not a lawyer, but it would make sense to me that some of that consent may already have been given because they already have to verify information. If I were on Medicaid, I wouldn’t assume I could just refuse consent and be fine. I really doubt that’s how that would work. Again, I’m not a lawyer, not a social worker, not a caseworker, and I don’t work for the government. I can’t say for sure, but it seems reasonable to think that some level of consent has already been built into existing documentation.
So just bear that in mind as things move forward.
The integration of this technology could also change what you report and how you report it. You may see new online portals, mobile apps, and automated phone lines. There may be more automation so that you don’t have to report as much manually. A lot of that will depend on how your state chooses to integrate this technology.
Just because a provider is listed on the federal CMS website doesn’t mean your state has to use that provider. States still have the ability to choose. CMS is simply listing the companies that have agreed to make concessions to make services cheaper.
What This Does Not Mean
I want you to understand a few important things.
Medicaid is not ending. Benefits are not being automatically cut across the board. These new rules are not active yet in most states.
Some of these tech providers may already be operating in certain states, but not necessarily all states. It does look like states are still building out these systems and working to integrate more of this technology. Those rules are supposed to go live by January 2027, and we’ll see how that goes as things progress.
Some states are implementing changes sooner. Make sure you’re watching your phone and your mail. Your state Medicaid office will send you notices about new requirements. Do not ignore letters or texts from Medicaid. Missing a deadline can put your coverage at risk, and I don’t want that to happen to you.
Also, those work requirements do not apply to everyone on Medicaid. The rules apply only to certain adults. Many people will be automatically exempt.
For example, if you have a disability, if you’re pregnant, if you’re a caregiver of a young child or a family member, or if you are considered medically frail, those are all reasons you can get an exemption and not have to worry about these work requirements. Each state does its own thing, though, so watch for those Medicaid letters so you don’t miss details for your area.
What You Should Do Now
First, make sure your contact information is updated with the Medicaid office. If they can’t reach you, they can’t update you about changes.
Second, watch for state notices. They will announce rules and timelines. Sometimes those announcements happen quietly, and you have to be proactive about checking their website and press releases. That’s what we do. If you stay subscribed here, we’ll do our best to help you stay on top of that information.
We also do a lot more state-specific deep dives on our second channel, Fast Facts by Low Income Relief. That’s where we put a lot of our state-by-state information.
Third, know your exemptions. If your situation qualifies you to be exempt, make sure you have documentation so you can secure that exemption as quickly as possible.
If you need help, contact your local Medicaid office or a benefits counselor. I am not one. I’m not licensed to help with specific cases. I’m just a researcher who’s here to make sure you don’t miss any updates.
If you are dual eligible for both Medicaid and Medicare, definitely give Chapter a call with any questions or concerns. They are fantastic. Calls take an average of about 20 minutes, and they’ve been amazing at answering my questions. I highly recommend giving them a call. That’s for people who get Medicare. If you get both Medicare and Medicaid, they can help you. If it’s just Medicaid, there’s not a lot they can do.
I hope this has been helpful to you. Please check out our other videos on the changes coming to Social Security and SNAP and everything else. It’s been a very busy week catching up on all of those updates. If you go to our channel and look at the recent videos, we’ve got a lot of other news for you.
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