Medicaid Changes: What You Need to Know

Beginning January 1st, 2027 are new changes for Medicaid coverage for current and future individuals from the ages of 19-64. Letters regarding Medicaid changes will be sent out August 1st. Participants must at the time of application on January 1st meet the requirements for 80 hours per month of either work, community service hours, certain work programs, or a combination of the above. Or if they are enrolled in educational programs for half time (which is federally defined as at least 6 credits per semester for higher-ed) in a higher-ed institute, career or technical education program, high school or high school equivalency, then they fulfill the requirement. An individual can also meet work requirements by earning $580 per month (which at Ohio’s minimum non-tipped wage is about 53 hours of work a month). Note that “Certain new Medicaid applicants will need to meet the requirement for at least one month before the month in which the applicant applies, and existing Medicaid beneficiaries will need to meet the requirement for one or more months between renewals.” (cms.gov)

For non-exempt individuals already enrolled in Medicaid, they must prove compliant prior to renewal and states will determine how many months they must meet this requirement for. If a state is unable to verify the individual has met the requirements, they must issue them a statement of noncompliance and give them 30 days to comply (cms.gov).

Exemptions for Medicaid work requirements are individuals with a dependent under 14 years of age, pregnant or postpartum individuals, disabled or medically frail (see here), American Indians and Alaska Natives, former foster care individuals up to age 26, participants in a qualifying substance use disorder program, incarcerated individuals, among others.

Some states may also be offering short-term hardship exemptions for people receiving certain medical services or those residing in a county with an unemployment rate of 8% or higher, but this is not yet confirmed for Ohio.

Medicaid is run through the county level in Ohio and local counties should be sending notifications by mail between August 1st to August 31st and through a second electronic method. To ensure Medicaid has a current address and phone number participants should log in to their account at https://benefits.ohio.gov/home or call 844-680-6446 and select the preferred language, then select option 2 and enter your zip code.