Medicaid

Implementing H.R. 1 in the open

Medicaid is a critical component of our safety net, providing health care for tens of millions of households every year. The passage of H.R. 1 brings significant legislative changes that state Medicaid agencies must implement while continuing to deliver excellent services.

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What we're building

Nava is building a new, open-source software solution to support states in implementing the Medicaid work requirements and complying with H.R. 1.

Our open-source community engagement reporting (OSCER) tool is a self-contained “sidecar” application that works alongside existing Medicaid systems. This approach enables states to achieve compliance almost immediately by extending system functionality without getting locked into proprietary platforms or expensive customizations.

In early 2026, state agencies will be able to pilot with OSCER, ensuring excellent experiences for Medicaid enrollees, caseworkers, and staff. OSCER’s technology is highly flexible, enabling states to adapt to new requirements as they’re released. All of this lets states focus on critical outreach, training, and support ahead of September 2026.

OSCER offers:

A solution that addresses the full breadth of Medicaid H.R. 1 scope

The ability to leverage ongoing improvements

A foundation that supports ongoing incremental modernization

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States will be able to re-use the resulting code and technology stack, which is designed to reduce the cost, time, and risk of implementation.

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How OSCER works

OSCER uses client and ex parte data from existing state systems to automatically certify compliance with H.R. 1. If OSCER cannot certify a client’s compliance, it provides the client with a link to manually certify their work requirements or apply for an exemption. Meanwhile, OSCER provides staff with case management and program reporting tools. Finally, OSCER sends the results back to the state Medicaid agency for issuance or disenrollment.

Iterating in the open

We’re committed to building OSCER in the open. Our code repository and roadmap are public and we’ll regularly host public demo days, publish progress reports, and share lessons learned from states.

Our priority is ensuring OSCER is highly usable for states with minimal integration effort. So far, we’ve focused on addressing the biggest eligibility bottlenecks with the lightest integration lift. As we learn more about the policy implementation and work directly with states, we’ll update our roadmap.

Why OSCER

Implementing H.R. 1 requirements doesn’t need to take months or exhaust your budget. We built OSCER to be a lower cost, lower risk, more efficient alternative to traditional vendor offerings.

Save money: OSCER’s open-source license enables government agencies to own their code while avoiding license fees and exorbitant legacy vendor pricing schemes.
Save time: We designed OSCER for minimal, rapid implementation. State teams can implement the application themselves, and in most cases, Nava teams can get OSCER into production for under $50,000.
Reduce risk: OSCER is built on human-centered best practices we developed over a decade of building best-in-class government services. Our methodology has proven successful in the most challenging digital transformation projects.