By: David Lewis | Published: October 14, 2026 | 
6 Min
Summary:
HR 1’s Medicaid work requirements and SNAP changes hit domestic violence survivors hard. Learn four steps DV programs can take now to protect coverage, confidentiality, and funding.
A survivor sits across from an advocate with a letter from the state Medicaid office. She has 30 days to show she’s working, in school, or exempt. The trouble is, she’s been in shelter for three weeks with two kids, one of them 15, and her paperwork is wherever she left it when she escaped her situation.
That scene is about to get more common. HR 1, the budget reconciliation law signed July 4, 2025 and enacted as Public Law 119-21, wasn’t written as a domestic violence bill. But its Medicaid and SNAP changes land squarely on the people DV programs serve, and they arrive while victim services funding is already strained.
To be clear, most programs I talk with don’t have a policy problem; they understand what’s coming. However, they do have a documentation problem that’s about to get urgent.
Here's what's changing, and four things you can do about it right now.
What's Changing
Medicaid Community Engagement Starts by January 1, 2027
Under the interim final rule CMS issued June 1, 2026, adults aged 19–64 in the Medicaid expansion group must show 80 hours a month of work, community service, a work program, or half-time school, or earn at least 80 times the federal minimum wage (CMS fact sheet). Compliance is checked at application and renewal. If the state can’t verify it, the enrollee gets a notice and 30 days to respond.
There are exemptions, and many survivors will qualify, e.g. parents and caretakers of children 13 and under, pregnant and postpartum individuals, people who are medically frail, and people in substance use treatment, among others. But neither the mandatory exemptions nor the optional hardship exceptions in the CMS rule name domestic violence specifically. A survivor has to fit another category, and somehow must provide the evidence necessary to prove it.
Renewals Get More Frequent
Starting with renewals on or after December 31, 2026, eligibility checks go from once a year to once every six months (National Council for Mental Wellbeing). And for someone who has moved twice since their last renewal, a notice sent to an old address is a coverage loss just waiting to happen.
SNAP time limits now reach more survivors. The SNAP changes took effect when the law was signed (USDA FNS memo). The time limit for adults without dependents now covers ages 18 through 64, up from 54. The parent exception now covers only children under 14, so in the case of the mother at the start of this article, whose child is 15 years old, she would no longer be exempt on that basis. And the temporary exception for people experiencing homelessness is gone, which matters for anyone in emergency shelter.
Immigrant survivors face new eligibility limits. HR 1 narrowed SNAP eligibility to lawful permanent residents, certain Cuban and Haitian entrants, and citizens of the Compact of Free Association nations. Refugees, asylees, and trafficking survivors without a green card are no longer eligible (FRAC). As of October 1, 2026, federally funded Medicaid follows a similar line (State Health and Value Strategies). If you serve survivors with pending or approved humanitarian immigration status, talk with your immigration legal partners now about who on your caseload is affected.
Funding isn’t keeping pace. Crime Victims Fund deposits have fallen for years. NNEDV reports that VOCA funds dropped by about $600 million from FY23 to FY24, an average 40% cut to state victim assistance grants (NNEDV). The House passed the Crime Victims Fund Stabilization Act (H.R. 909) in January 2026 (CSAC). Meanwhile, federal agencies are running on a continuing resolution through December 11, 2026 (CRS).
Four Things You Can Do Now
Know Who on Your Caseload is Affected
You can't plan for a change one crisis at a time. Look at your program in aggregate and determine how big the impact will be: how many adults you serve are 19–64, how many have children 13 and under, how many have teenagers only, how many are in shelter, and how many hold humanitarian immigration status. You don't need names to do this: aggregate, de-identified counts are enough to size the workload and brief your board. And if your data system can't answer those questions in an afternoon, that's worth knowing before January, not after.
Treat Documentation as a Service
The 30-day response window is where survivors lose coverage—not because they don't qualify, but because they can't produce proof fast enough while managing safety, housing, and kids.
Advocates can close that gap. With the survivor's consent, a program that can quickly produce a letter confirming shelter residence, program participation, or caregiving gives them what they need to respond. Build a standard letter now, decide who signs it, and make sure staff know where the records live.
During the pandemic Medicaid unwinding, procedural disenrollments drove much of the coverage loss, where people lost coverage over paperwork rather than eligibility (National Council for Mental Wellbeing). Keeping current contact information on file, with the survivor's permission and a safety plan for how mail and calls reach her, is one of the simplest protections you can offer.
Guard Confidentiality as Verification Ramps Up
More verification means more requests for information. Some will come from survivors who need records, while others may come from agencies, employers, or partners trying to confirm eligibility.
The rules haven't changed. VAWA, VOCA, and FVPSA bar programs from sharing personally identifying information about survivors without informed, written, reasonably time-limited consent, and programs can't make signing a release a condition of service (NNEDV Safety Net). Victim service providers still can't enter identifying information into HMIS; HUD-funded providers use a comparable database instead.
This is a good month to review your release forms and make sure staff can explain, in plain language, what a release does and what happens if a survivor says no. It's also a good time to check that your system keeps data from different programs separate, logs who sees what, and supports time-limited releases.
Build the Case Before the Next Funding Cut
In a one-day count cited in NNEDV's FY27 funding factsheet, programs served 84,146 victims, while 13,018 requests went unmet. 58% of those unmet requests were for safe housing (NNEDV). National numbers like these open doors. Your own numbers keep them open.
Women Against Abuse in Philadelphia is a good example. They served 11,701 adults and children in FY26, up from 10,592 the year before, while government contracts stayed flat. Their evaluation team rebuilt their state coalition report to match funder definitions and refreshes leadership dashboards three times a month. As their Director of Evaluation and Learning, Maria Giraldo Gallo, puts it: "Having quality data is how we maintain our funding."
If HR 1 increases demand on your program, as more survivors seek help with benefits, housing, and documentation, you'll want to show it. Start tracking benefits-related assistance now so it appears in your next grant report.
The Bottom Line
HR 1 doesn’t change what survivors need; it changes how much paperwork stands between them and the help they qualify for. Programs that prepare now, by knowing their numbers, making documentation part of advocacy, holding the line on confidentiality, and telling their story with data, will be in a far better position on January 1 than those that wait for the first notices to arrive.
See How One Organization Does It
Join our webinar on November 12 with Women Against Abuse to explore how collaboration and data can strengthen survivor support and demonstrate impact.
Disclaimer: This article is for general information and isn’t legal advice. Rules vary by state. Check with your state Medicaid and SNAP agencies, your state DV coalition, and legal counsel for guidance specific to your program.
About the Author
David Lewis
As Vice President of Product Marketing at CaseWorthy, David partners with communities to leverage the power of technology in addressing complex social and health services needs. Drawing upon extensive experience integrating policy and governance best practices with innovative technological strategies, David focuses on creating solutions that elevate service delivery and produce measurable, lasting outcomes. His commitment centers around supporting and empowering vulnerable populations, ensuring technology acts as a bridge to greater equity, access, and impact across the social and health sectors.
