A guest post by Matt Darling on Don Moynihan's Can We Still Govern? blog examines what states' earlier Medicaid work requirement efforts can teach as HR 1, signed July 4, 2025, makes the policy mandatory nationwide. Drawing on Arkansas and especially New Hampshire, where even 50,000 phone calls reached only about 500 people, Darling argues the requirements keep backfiring, with paperwork failures costing people coverage, and urges states to plan early, share resources, and design plain-language outreach to soften the harm.