It has been more than a month since Montana rolled out new Medicaid work requirements, and budget experts said they do not know much about how it is going so far.
On July 1, Montana started requiring Medicaid enrollees to work 80 hours a month, attend school or training, or qualify for an exemption.
Heather O'Loughlin, executive director of the Montana Budget and Policy Center, a nonpartisan, nonprofit group focused on how policies can help low- and moderate-income earners in the state, said Montana's health department has not released updated information.
"The state has not yet reported publicly how many individuals have received notification, how many have been determined in compliance or exempt through ex parte data, or how many Montanans they believe to be out of compliance," O'Loughlin explained.
"Ex parte data" refers to information the health department already has from case files and other resources to determine eligibility.
Medicaid's community engagement requirements, more commonly called work requirements, were part of the Republicans' budget bill passed in July 2025. The health department said the changes will help enrollees rely less on the government and increase personal responsibility. Montana is the second state to start the requirements early. Nebraska began enforcing them on May 1.
O'Loughlin pointed out Medicaid advocates are still concerned about the state's capacity to verify compliance with the new rules. Montana's health department has said it is hiring 59 new employees to handle the workload. Even so, O'Loughlin noted many Medicare recipients are worried and confused.
"These are workers and caregivers across our state and some facing serious medical conditions that have relied on Medicaid coverage to access treatment, prescription drugs and preventative care," O'Loughlin stressed.
O'Loughlin added letters the health department sent in June added to the confusion, with recipients thinking they needed to prove compliance within 30 days, even though their redetermination date was months away.
The state has a three-month "hold harmless" period, where people will not lose their Medicaid coverage for noncompliance, as long as they meet all other eligibility standards. It ends Sept. 30, and afterward, people could lose coverage if they are not following the rules.