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Arizona Medicaid work requirements are 6 months away. What to know

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Arizona Medicaid work requirements are 6 months away. What to know


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Not a day goes by without staff at the Valle del Sol health clinic in Phoenix strategizing about the looming date of Jan. 1, 2027, and what it will mean for their low income patients’ health coverage.

“We will absolutely see a spike in uninsured people. My biggest concern is that people who are eligible will be cut because of the administrative burden,” said Mike Renaud, the CEO of Via del Sol, a federally qualified community health center that sees roughly 15,000 patients per year, half of whom are covered by Medicaid, which in Arizona is called the Arizona Health Care Cost Containment System or AHCCCS, pronounced “access.”

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“Medicaid is the largest health insurance program for low income people in the United States. It is the largest payor of mental health services in the U.S.”

Jan. 1, 2027 — six months away — is the deadline for Medicaid programs in 43 states across the country, including Arizona, to implement major policy changes that include work requirements and twice-yearly renewals (up from once yearly) for certain enrollees.

In Arizona, the new rules will mark the largest operational change in the history of the AHCCCS program, said Meaghan Kramer, health policy adviser to Gov. Katie Hobbs.

“This is the fastest they’ve ever had to do something that is operationally complex. And this is the most operationally complex thing they’ve ever had to do,” Kramer said. “We’re straining existing systems that are already old and overburdened on the IT side. And we will need much, much more work on the eligibility side than we have now.”

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The changes are a result of HR1, the budget reconciliation bill also known as the One Big Beautiful Bill Act, which President Donald Trump signed into law on July 4, 2025.

The law significantly changes both eligibility and financing of Medicaid, which is a government health insurance program primarily for low-income people that has been in place since 1965. Arizona has had a Medicaid program since 1982.

Having only 18 months to prepare for HR1 is an extremely heavy technological lift for states, including Arizona. Arizona’s aggressive implementation of HR1 changes to SNAP, the Supplemental Nutrition Assistance Program once known as food stamps, resulted in the highest rate of loss of SNAP recipients in the country, with about 450,000 dropping from the program from February 2025 to mid-2026.

Recipients and would-be recipients have told The Arizona Republic SNAP benefits are harder to get than ever, with long hold times on the phone and at satellite offices, a dysfunctional website and fewer DES employees to help them.

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The new state budget that was recently signed includes a little more than $10 million that will go to technology and to employees who will be handling the increased workload, Kramer said.

Hopefully state officials have learned from the experience with SNAP and “don’t make the same mistake again,” said Will Humble, executive director of the Arizona Public Health Association.

“The computer system needs to improve and the staff needs to be trained,” Humble said. “I’m convinced the majority of people who lose coverage will lose it because of administrative reasons.”

Further complicating the implementation is that the Centers for Medicare & Medicaid Services recently released a 387-page interim final rule with strict new guidelines about Medicaid work requirements. The new guidelines, for example, do not automatically exempt people with cancer and end-stage renal disease, among other conditions, from the work requirements.

“It is written in a way that makes it clear this is going to be a much more challenging task than any state anticipated,” Kramer said of the guidelines. “States are really struggling with what this new guidance means…The new guidance is going to be much more burdensome on the member, the applicant and the Medicaid agency long-term.”

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Twenty-four attorneys general, including Arizona Attorney General Kris Mayes, and two governors on June 30 sued the federal government over the document, arguing that it illegally narrows congressional protections of medically frail people enrolled in the program.

AHCCCS as of June 1 provided health insurance to approximately 1.8 million Arizonans, which works out to one in four state residents. About one in four of those AHCCCS enrollees or 400,000 and 500,000 people, are expected to be part of the adult expansion population affected by the work requirements and twice-annual renewals.

At Valle del Sol, Renaud said clinicians and other staff are already educating patients and clearing up misinformation.

“We want to make sure they understand this is not a Medicaid cut. It is increased barriers to maintaining coverage.”

Here are seven things to know about the coming changes to Medicaid in Arizona:

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Outreach to AHCCCS enrollees begins in September

AHCCCS will be providing communications to impacted enrollees by Sept. 1. Most enrollees probably don’t know whether they are part of the affected adult expansion population and that’s part of the outreach. People covered by AHCCCS can expect to see communications via mail, text and email.

“The goal will be to make sure we are providing reliable information to everybody to reassure folks that they should continue to fill out paperwork when they are prompted by their health plan or by AHCCCS,” Kramer said.

 For now, there is nothing Arizonans need to do, AHCCCS officials say, except to keep their contact information current on Health-e-Arizona Plus; respond if AHCCCS or your health plan reaches out to you; and watch for official updates from AHCCCS, not third parties.

The changes won’t hit all affected enrollees at once

Annual AHCCCS renewals (also known as redeterminations) happen on a rolling basis, and that’s how the twice-annual renewals and work requirements will be handled, too, Kramer said.

“If they were redetermined last Jan. 1 they will get redetermined again the next Jan. 1. And then beginning that year they are getting redetermined every six months,” she said.

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The work requirements allow for volunteer work and school

Enrollees who are part of the adult expansion population will need to prove they are working at least 80 hours per month or doing another qualifying activity, like job training or education, to avoid losing coverage. 

It’s unclear how enrollees prove they are working, volunteering

State officials are able to verify through pay stubs that some people are already meeting the work requirements, but not for everyone. And at some point “self-attestation” − simply saying you are volunteering or in school − won’t be enough.

“What we know is the rules are more aggressive beginning in year two (2028) and there will be some allowance for self-attestations in the first year,” Kramer said.

“But after the first year, beginning Jan. 1, 2028, self-attestations are only permitted once in a continuous eligibility cycle. So that would place an enormous burden on AHCCCS and DES (the Arizona Department of Economic Security), which plays a large role in Medicaid eligibility determinations.”

Kids, seniors and Native populations won’t be affected

Several categories of Arizona’s Medicaid expansion populations will be exempt from the work requirements, such as but not limited to, pregnant and postpartum women, people who are disabled or medically frail, parents and caretakers of children under 14, caregivers of someone with a disability, American Indians and Alaska Natives, and those already meeting similar requirements under SNAP.

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Kramer said that state officials are working to determine on their end who is exempt from the requirements in order to lessen the burden on enrollees.

Arizona will be offering short-term hardship exceptions to the work requirements for people who have recently been hospitalized, who need to travel outside of their community for medical care, who live in a county with high unemployment rates, or who live in a community where a national emergency or disaster has recently been declared, Cordoba, the AHCCCS spokesperson, wrote in an email.

Technology could be a problem in Arizona

AHCCCS relies primarily on two major systems to administer eligibility and benefits and both are old.

PMMIS, the agency’s core Medicaid administration system, was originally implemented in 1991 and is currently undergoing modernization, with the updated platform scheduled to go live in October 2027, Cordoba wrote. HEAplus, Arizona’s eligibility system, was implemented in 2013.

“While both systems have undergone significant upgrades and enhancements over time to support changing federal and state requirements, the PMMIS modernization project will not be complete before the federal requirements in H.R. 1 take effect,” Cordoba wrote.

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Health entities are trying to prevent AHCCCS coverage losses

Hospitals, community health centers and health plans already connect people to benefits, including AHCCCS. One of the key goals of those entities statewide is to ensure enrollment specialists are all trained on how to interact with the technology that’s going to be used to implement HR1, Kramer said.

All those entities have an interest in keeping people insured. Without health insurance, people tend to wait until their health problems reach a critical point before seeking care, which can cause personal medical debt, bad debt for hospitals, and increased health costs across the board.

The Health System Alliance of Arizona, which includes major Arizona health systems such as Banner Health and HonorHealth is “extremely concerned about eligible individuals losing Medicaid coverage due to the increased renewals and work requirements passed in HR1,” Brittney Kauffmann, alliance CEO wrote in an email.

“Our systems are assessing all options to ensure Medicaid members are aware of these changes.”

Reach health-care reporter Stephanie Innes at stephanie.innes@usatodayco.com or follow her on X@stephanieinnes or on Bluesky: @stephanieinnes.bsky.social.

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Snake Bytes 8/16

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Snake Bytes 8/16


Team News D-backs finally putting pieces together as NL Wild Card battle heats up“Everybody in that room believes we can tell a really good story and our journey is very incomplete,” said manager Torey Lovullo. “We have to go out and continue to play good baseball. At our core in this organization are pitching and […]



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Red team wins Arizona volleyball Red-Blue scrimmage

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Red team wins Arizona volleyball Red-Blue scrimmage


The Red team during Arizona volleyball Red-Blue intrasquad scrimmage
Photo courtesy of Arizona Athletics

Saturday’s Red-Blue intrasquad scrimmage showed some of the promise of the 2026 Arizona Wildcats and answered some of the questions, but there were still some left open when the Red team emerged victorious in four sets (20-25, 27-25, 25-18, 15-10).

Red was superior in kills (56-35), hitting percentage (.181 to .109), and blocking (10.0 to 5.0). Both teams had four aces, but they struggled overall on serve.

The initial team lineups were made to be as competitive as possible. Neither team was dominated by presumed starters or returners from last year’s team. After the second set, the roster was shaken up where more of the returners and presumed starters were stacked on the Blue team, but that didn’t slow down the Red squad.

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The Blue team started with Carlie Cisneros and Payton Woods at outside hitter, Britt Carlson at opposite, Journey Tucker and Maya Flemister at middle blocker, Harmony Sample setting, and Brenna Ginder at libero.

Red featured Destiny Ndam-Simpson and Hayden Reeder on the left side, Kennedy Osunsanmi on the right, Mo Siapani at setter, Kristen Dear and Marina Vosloo at middle, and Brookelyn Hatton at libero.

Eventually, Ginder, Ndam-Simpson, Osunsanmi, Flemister, Carlson, and Woods would flip sides. Hatton took off the libero jersey in favor of freshman Gigi Whann for a while, as well.

A big concern for Arizona has been who would score after the graduation of Jordan Wilson. Ndam-Simpson showed that she’s ready to step into that role.

“She can do all do it all as an attacker,” said Arizona head coach Rita Stubbs.

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The transfer from Creighton had 24 kills on .177 hitting. She was both more efficient and effective in the first two sets when on the Red team. She had 17 kills on .263 hitting before switching sides.

“I have a lot of things that I’ve been working on that I’ve been growing in attacking and passing, especially passing,” Ndam-Simpson said. “Building consistency there has been huge for me, and continuing to just have confidence and belief in myself that I can do it.”

Woods had some success on the attack, but she also showed where she needs to improve her game. She had 4 kills, but they were offset by 5 errors. The strongest part of her game turned out to be her block, where she was good for 3 total blocks. Two of them were solo.

“It’s something to make the right sides think,” Woods said of her blocking. “Normally, right sides is like one of your big attackers. They’re normally really tall. So for me, just focusing on getting up and over the net, pressing, taking their best swing, and it definitely helps the defense. Especially when I’m in middle back and I have a good block set up.”

The Wildcats got scoring on the right side from all three opposites. Each stood out in different ways. Carlson didn’t play in the fourth set, but she ended her three-set day with 7 kills on .208 hitting and a team-high 6 total blocks. Osunsanmi had 9 kills on .259 hitting and 1 total block. Renee Jones, who played all four sets on the Red team, had 5 kills on 13 swings without an error. She also threw in a block assist.

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The Red team had a wrinkle in their rotation with Siapani occasionally coming out for an opposite when she rotated to the front row. The Wildcats went without a setter on those occasions with the libero typically bump setting the ball. The change was to address the issue of having a small setter in the front row.

“That’s something that we’re going to have to do if she’s the setter that wins out,” Stubbs said. “You know, the teams are going to go right after her because she has a small presence, and so you put a bigger block in because we have three opposites that are able to play, and then you run that offense that time without a setter on the floor. We have people that are capable.”

In the middle, Tucker tied Carlson with 6 total blocks, but one of hers was solo. She also had 5 kills but countered with 5 errors for a .000 hitting percentage.

When asked to name a player who was especially impressive, Stubbs singled out Flemister. The sophomore played on both teams. She had 2 kills on 5 swings without an error. She added 5 total blocks.

“She showed that she was able to play the entire time, and as a blocker and as an attacker, so she stood out in a good way to me,” Stubbs said.

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The competition for setter continues to be the biggest question for Arizona. Sample is taller and she spread the ball around nicely, finding her opposites on a regular basis. However, the hitters on Siapani’s team were more efficient. Her sets turned into kills at a .357 clip while Sample’s scored at a .248 clip. Siapani actually had 6 fewer attempts than Sample, but her side scored on 41 of her sets compared to 30 for Sample.

The biggest problem for all of the Wildcats was serving. As the match wore on, it became a war of service errors.

“We have to be able to serve the ball in the court,” Stubbs said. “That goes without saying. There is a philosophy, if you just go after it as hard as you can, eventually it’ll go in. But we’re missing balls that were way too long, that there was not a chance that it was going to go in. So for me, it’s about serving and passing, and then everything else will come.”

Overall, though, there were positives that came out of the scrimmage if only getting on the floor in front of fans.

“We didn’t serve very well, but I’m excited about the group, and I’m excited that they got a reality check of what volleyball looks like and what we need to do more of,” Stubbs said.

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Arizona football training camp: A fresh crop of safeties take shape

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Arizona football training camp: A fresh crop of safeties take shape


Arizona safeties coach Brett Arce took time from a busy Thursday evening to catch some NFL preseason action, where several of his former pupils were notching their first reps as professionals.

The debuts of Dalton Johnson and Treydan Stukes of the Las Vegas Raiders and Genesis Smith of the Los Angeles Chargers brought Arce much delight. All three developed into NFL Draft picks under his tutelage.

“I was so proud of those guys,” Arce said. “And then just to see the reaction of all their teammates. Everybody’s cheering when they’re making the plays.”

Their presence in the NFL is also a reminder of how much talent Arizona needs to replace at the safety position. The Wildcats’ safeties room this summer is full of new faces, including several transfer portal additions.

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Arizona returns two players at the position in senior Johno Price and sophomore Dajon Hinton, who is recovering from a knee injury he suffered in the Holiday Bowl. Joining the group are Matai Tagoa’i (USC), Lee Molette (UConn), Daylen Austin (Oregon) and Cam Chappa (Northern Colorado). Former walk-on Quinn Olson is also expected to see significant playing time.

“It’s been a revolving door, just trying to mix and match guys,” Arce said.

Arce said he’s been rotating guys around during training camp as the coaching staff develops trust with each player.

“Can I trust them to not have mental errors and do all the little things that Coach (Danny Gonzales) and the defenses asks?” Arce said.

Of the newcomers, Tagoa’i might have the highest ceiling as a former four-star recruit who played linebacker in his one season at USC. The 6-foot-4 Tagoa’i played some safety at San Clemente High School in Southern California.

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Tagoa’i has spent the summer adjusting to his position by focusing on pre-snap alerts, motions and eye control. Much of his studying has come from watching film of Johnson, Stukes and Smith at Arizona.

“He’s definitely trying to preach to us that that’s what it looks like to get to the next level,” Tagoa’i said. “We watch their stuff dang near every day.”

Whereas Tagoa’i is getting up to speed at the safety position, experience is no issue for Molette, the UConn transfer. The redshirt senior appeared in 38 games during his career with the Huskies.

Arce calls him the “Swiss army knife” on the unit.

“He knows all the positions, so that’s a comforting thing for me. And it gives him more opportunity get on the field,” Arce said. “He’s really shown and taken steps forward this fall camp, making plays, being in the right spot, showing up in the run game.”

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Chappa is another newcomer who Arce and the coaching staff envision having a big impact. Chappa earned First team All-Big Sky honors last season at Northern Colorado, leading the conference with 63 solo tackles.

Having so many newcomers at one position has helped players pick up on what they need to improve on by watching others go about their drills.

“It’s definitely helpful having these new faces because when we’re in the process of learning everything, Arce has been preaching to us about versatility and playing all three spots (at safety),” Tagoa’i said. “It’s beneficial for me because I’m watching everybody — not just the reps I get on the field but the mental reps everybody else is getting as well.”

For Arce, the amount of teaching that goes into integrating a new crop of players comes with a learning curve. That’s fine, he said, as long as players are giving maximum effort.

“There’s some growing pains through that, and that’s okay,” Arce said. “That’s what I tell those guys. You’re going to make mistakes. There’s going to be some growing pains, as long as we’re going 100 miles an hour, we can correct and coach off those growing pains.”

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