06/18/2026
Medicaid News & Updates
Federal Work Requirement
Cardinal
Beginning in January 2027, a new federal law requires adults enrolled in Medicaid Expansion 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 Expansion coverage. These same adults will also have their coverage reviewed every 6 months, instead of every 12 months.
Who must meet the new Medicaid work requirement?
The new requirement applies only to members enrolled in Medicaid Expansion. Medicaid Expansion covers individuals who are between 19 and 64, have income under 138% of the federal poverty level (FPL), and are not eligible for Medicare. Most Medicaid covered adults in this age range are in Medicaid Expansion.
This requirement DOES NOT apply to children, pregnant or postpartum individuals, or adults with a disability or who are over 65.
How will someone know if they are enrolled in Medicaid Expansion?
Medicaid Expansion members will be mailed a notice by the end of September 2026 telling them about the new requirement. They can also call Cover Virginia at 855-242-8282, or contact their local Department of Social Services.
What must a member do to comply with this new requirement?
The new requirement can be fulfilled in a few different ways. Individuals can:
Work, participate in a work program, attend school, and/or volunteer for at least 80 hours a month in total. Work can include both in-kind and unpaid work, such as receiving free or reduced cost housing as compensation for work.
Be enrolled in school (including high school, GED program, higher education, career, and technical education) at least half time.
Have monthly income that is at least equal to $580. (For a seasonal worker, the average income over 6 months must be equal or higher than $580.)
Who can be exempt from the new requirements?
Some Medicaid Expansion members may be exempt, including:
People with blindness or a disability, such as those receiving Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI)
People who are pregnant or within 12 months of the end of a pregnancy
Former foster care youth who are 25 or younger
Parents and caregivers of a child age 13 and younger, or a person of any age with a disability
Veterans with a 100% disability rating
Members of federally recognized tribes
People who have a serious or complex medical condition that makes it difficult to meet the requirement, including a behavioral health condition 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)
People who are incarcerated, or were released from incarceration in last 3 months
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 expansion coverage. These same adults will also ...
