5 Things to Know: Medicaid Work Requirements
September 08, 2026
Medicaid work requirements are coming to Pennsylvania next year, and the effort to keep enrollees covered is underway.
Last month, Pennsylvania’s Department of Human Services (DHS) began to notify beneficiaries about what they need to maintain their Medicaid coverage. The goal is to ensure beneficiaries know how to meet work requirements and who is exempt from the new rules.
Here’s what you need to know:
- Who it affects: Starting January 1, 2027, Medicaid applicants and recipients need to meet the work requirements if they are between 19–64, do not have a dependent child under 14, or a qualifying exemption.
- Why it matters: State officials have estimated as many as 310,000 residents could lose Medicaid coverage due to changes related to H.R. 1. State leaders are helping Medicaid enrollees understand their new administrative requirements ahead of these changes.
- More to come: Starting next year, Medicaid renewals will occur every six months, instead of every year.
- During enrollment, retroactive coverage for medical expenses will be shortened to the month of application compared to the current three-month period.
- Strategies for change: In a webinar with HAP, DHS highlighted how it’s using claims data, when possible, to help verify beneficiaries are meeting work requirements or may qualify for exemptions.
- 3 Things to do: Medicaid enrollees should ensure their address is up to date with DHS and report changes online.
HAP continues to communicate with DHS about the upcoming Medicaid work requirements and the implications for hospitals and the patients they serve.
Providers can support education via this DHS communications toolkit. A summary of upcoming Medicaid changes is available online. For additional information, contact Jolene Calla, Esquire, vice president, finance and legal affairs.
Tags: Access to Care | State Advocacy | Regulatory Advocacy | Medicaid