09/04/2026
Millions of beneficiaries across 44 state programs will have their eligibility re-examined by January 2027. Under the One Big Beautiful Bill Act (H.R.1), adults who became eligible for Medicaid under the Affordable Care Act must complete qualifying work activities or demonstrate an exemption, and states are now required to check Medicaid eligibility at least twice a year.
Facing compressed timelines and limited staff, states are looking to AI to automate the process; six agencies have already committed to using AI tools, and 21 more are considering it.
SHP’s Michelle Mello, JD, PhD, a professor of law and health policy, and Himaja Nagireddy, MS, a second-year doctoral student, write in this JAMA Health Forum article that AI could help states manage this looming workload if deployed carefully. If rolled out too broadly or too quickly, however, AI could make the law's effects on beneficiaries even worse.
Stanford Health Policy is a joint effort of the Freeman Spogli Institute for International Studies and the Stanford School of Medicine