By January 2027, 44 state Medicaid programs must redetermine the eligibility of millions of beneficiaries under criteria in the 2025 budget reconciliation law (HR 1). Among the changes are “community engagement” (work) requirements and increased redetermination cadence (from annual to at least semiannual). In preparation, state Medicaid agencies have been exploring technological solutions to automate redeterminations at scale, including artificial intelligence (AI). Six agencies have decided to use AI tools so far and 21 states are considering use of them. Strategic deployment of AI can help states tackle the redetermination juggernaut,¹ but overly broad or hasty deployment could compound the harms of HR 1.