Perspectives

Timely commentary on Medicaid policy developments, CMS actions, published reporting, implementation choices, and emerging operational issues.

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October 1 Changes the Federal Matching Rules. Eligibility Systems Have to Be Ready First.

Perspectives

Aug 27, 2026

October 1 Changes the Federal Matching Rules. Eligibility Systems Have to Be Ready First.

New Medicaid and CHIP federal funding limits for certain noncitizens turn status verification, case evidence, and system logic into immediate fiscal-control issues.

Ralph Choate

2027 Is a Dual Eligibility-Control Change, Not a Single Work-Requirement Project

Perspectives

Aug 27, 2026

2027 Is a Dual Eligibility-Control Change, Not a Single Work-Requirement Project

Six-month redeterminations and community-engagement verification will arrive on the same operating platform—and states should govern them as one control environment.

Ralph Choate

2027 Is Not the Work-Requirement PERM Test. It May Be the Rehearsal.

Perspectives

Aug 26, 2026

2027 Is Not the Work-Requirement PERM Test. It May Be the Rehearsal.

CMS will make RY2027 an eligibility-only PERM cycle while states prepare for new Medicaid community-engagement requirements. The timelines do not directly overlap—but the operational lesson does.

Ralph Choate

Perspectives

October 1 Changes the Federal Matching Rules. Eligibility Systems Have to Be Ready First.

2027 Is a Dual Eligibility-Control Change, Not a Single Work-Requirement Project

2027 Is Not the Work-Requirement PERM Test. It May Be the Rehearsal.

PERM Insights & Perspectives