If you opened your mail and found a letter about a new Medicaid work requirement, you are not alone. States are sending these letters now, between the end of June and the end of August 2026, to let people know about a new rule. This article explains what the letter probably means and what to do about it, in plain language.
Why you got this letter
A new federal law called H.R.1 changes the rules for some adults who have Medicaid through their state's expansion program. Starting January 1, 2027, some adults ages 19 to 64 will need to report work, school, volunteering, or job training hours to keep their coverage, unless they qualify for an exemption. Your state is required to tell people about this ahead of time, which is why the letter arrived now instead of closer to the deadline.
This does not mean you are losing coverage right now
Getting this letter does not mean your Medicaid is ending today, or that you did anything wrong. It is a heads-up, sent months before anything changes. The new rule does not start until January 1, 2027. The letter is meant to give you time to figure out whether it applies to you and what to do next.
You may not have to do anything — or you may be exempt
Not everyone on Medicaid is subject to this requirement. Many people are likely excused, including people who are pregnant, people caring for a young child or a family member with a disability, people who are medically frail, students, and several other groups. You may also already be exempt without needing to do anything, if your state's records already show your situation. But do not guess — the only way to know for sure is to check with your state.
What to do this week
Read the whole letter, even if it looks long or confusing. Look for a phone number or a website — that is how you find out your specific situation, not from a friend, a social media post, or this article. If the letter asks you to confirm your information, report hours, or claim an exemption, do it as soon as you can, and write down the date you responded. If your address or phone number has changed recently, update it with your state Medicaid agency right away, because a letter that cannot reach you cannot help you.
Why acting now matters
In Arkansas, when a similar rule was tried in 2018 and 2019, about 18,000 people lost their coverage — and most of them lost it not because they were ineligible, but because of paperwork problems: a form that was missed, a deadline that passed, or confusion about what to do. The people most likely to lose coverage under the new rule are not people who do not qualify. They are people who never respond to a letter like this one, or respond too late. Reading your letter and calling the number on it is the single most protective thing you can do right now.
What the letter is not asking you to do
The letter is not asking you to pay a fee, give your bank information, or make an immediate life-changing decision. If a message about your Medicaid asks for payment or banking details to keep your coverage, that is a warning sign, not a normal part of this process. Real notices about the work requirement come from your state Medicaid agency or your health plan, and they will always give you an official phone number or website to confirm anything you are unsure about.
If you are not sure who to trust
You may see ads, emails, or messages claiming to help with Medicaid work requirements. Be careful. The safest first step is always the number or website printed on your own letter, or your state Medicaid agency's official website. Community health centers, clinics, and Medicaid navigators can also help you for free — you do not need to pay anyone to understand your notice or file an exemption.
Remember: only your state Medicaid agency can confirm your status. Use the phone number or portal on your notice before making any decision about your coverage.