Community Engagement & Work Requirements
Starting January 2027, a new federal law will require certain adults to work or do other activities (such as volunteering or participating in a work training or education program) for at least 80 hours a month, unless exempt, to qualify for Medicaid. These same adults will also have their coverage reviewed every 6 months, instead of every 12 months.
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Community engagement and work requirements apply only to adults in Medicaid Expansion. Medicaid Expansion covers adults who are between 19 and 64, have income under 138% of the federal poverty limit (FPL), and do not have Medicare. The new requirements DO NOT apply to other types of Medicaid, such as coverage for children, pregnant and postpartum individuals, or adults with a disability or over age 64.
The new requirements can be met by:
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- Working, participating in a work program, attending school, and/or volunteering for a combined total of 80 hours or more a month.
- Enrolling in school (including higher education and career or technical education) at least half time.
- Have monthly income that is at least equal to the monthly income of someone who works 80 hours a month and is paid the federal minimum wage ($7.25/hour).
- If work is seasonal, the average income over 6 months must equal or be more than this threshold.
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Certain people will be exempt from the requirements:
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- Children who are 18 or younger and adults who are 65 or older
- People who are pregnant or within 12 months of the end of a pregnancy
- People who left foster care at age 18 and are currently 25 or younger
- Parents and caregivers of a child age 13 and younger, or a person of any age with a disability
- Members of federally recognized tribes
- Veterans with a 100% disability rating
- People who are incarcerated, or were released from incarceration in last 3 months
- People who qualify for Medicare Part A or are enrolled in Medicare Part A or Part B
- People with a disabling condition or who have special medical needs (also referred to as medically frail), such as:
- A disability as defined by the Social Security Administration, including Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) recipients.
- Disabling behavioral health disorders
- Substance use disorders
- A physical, intellectual, or developmental disability that significantly impairs a person’s ability to perform 1 or more activity of daily living (such as bathing, dressing, feeding themselves or using the bathroom)
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Find more information about the new requirements in the Community Engagement & Work Requirement FAQ.
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