The Centers for Medicare and Medicaid Services (CMS) announced that ten Medicaid IT services companies are agreeing to provide technology at little or no cost, saving states hundreds of millions of dollars in implementing work requirements.[1][9] These agreements are intended to make it easier for states to implement the controversial policy of tying Medicaid eligibility to work or approved activities.[1] The requirement requires people ages 19 to 64 in the Affordable Care Act's Medicaid expansion to do at least 80 hours a month of work, volunteering, education, or a combination of these activities.[1][4][8] States can simplify verification by integrating the Medicaid and SNAP systems so that SNAP automatically certifies eligibility for Medicaid without additional paperwork.[1] Nebraska plans to be the first state to implement the requirements beginning May 1, 2026, although a nationwide start is scheduled for January 1, 2027, with a possible extension to December 31, 2028.[1][4][7] CMS issued initial guidance on December 8, 2025 and expects more in 2026, acknowledging the need for changes in IT systems and processes.[5][6][8] These changes apply to Medicaid expansion programs or similar through waivers for adults 19-64 without pregnancy or Medicare.[5]