State tracker

Pennsylvania — Medicaid Coverage Retention

Applies Last updated 2026-06-03 · confidence: high

Pennsylvania is subject to federal Medicaid community-engagement/work-requirement implementation beginning January 1, 2027, unless modified by future federal or state guidance.

Procurement / RFP activity

None identified

No public RFP for work-requirement communications/outreach identified as of 2026-06-03.

Procurement portal: Pennsylvania eMarketplace (emarketplace.state.pa.us) — Commonwealth solicitation portal; DHS procurements run through the DHS OA-Bureau of Procurement and Contract Management. Federal/sub-related opportunities would also appear on SAM.gov. · Implementation funding: Pennsylvania DHS (Secretary Val Arkoosh) estimates ~$50 million for technology/system upgrades to support work-requirement (community engagement) verification, plus an estimated ~250 new hires and retraining of ~6,000 county-assistance-office staff. No dedicated, separately-procured communications/outreach budget figure has been published; outreach (mail/call/text) appears to be handled in-house by DHS. H.R.1 provides limited federal implementation funding to states; the $600M CMS-brokered tech-company pledge is national, not a PA-specific award.

Latest detail

As of June 2026, Pennsylvania is in active implementation planning for H.R.1/OBBBA Medicaid community-engagement (work) requirements that take effect January 1, 2027, for non-exempt expansion adults ages 19-64 without a dependent child under 14 (80 hours/month; PA uses a one-month look-back). DHS Secretary Val Arkoosh has publicly described an estimated ~$50M in system/technology upgrades, ~250 new hires, and retraining of ~6,000 county-assistance-office workers; DHS plans to begin beneficiary outreach (mail, phone calls, texts) by September 2026 to meet the federal requirement that enrollees be notified no later than August 31, 2026. CMS issued its interim final rule (CMS-2454-IFC) implementing the requirement around June 1, 2026, and DHS has released draft strategies (e.g., medically-frail exemption approach) that are not yet CMS-approved. No public Pennsylvania solicitation specifically for work-requirement member communications/outreach/advertising, or for a community-engagement eligibility-system build, was found on the PA eMarketplace, SAM.gov, or in news coverage; the outreach appears to be administered in-house rather than via an external comms RFP.

Medicaid expansion status	Expanded
Implementation status	Planning for Jan 1, 2027; DHS outreach to begin by September 2026; flagged significant implementation challenges (staffing, ~$50M tech upgrades, undefined "medically frail")
Who may be affected	Yes — expansion adults
Reporting frequency	Pending state guidance
Reporting method	Pending state guidance
Renewal cadence	Every 6 months for expansion adults (H.R.1)
Notice timing	Pending state guidance
Self-attestation allowed?	Pending state guidance
State system / vendor	Pending state guidance
Major Medicaid MCOs	Pending state guidance
Languages likely needed	Pending state guidance

Key exemption categories to monitor

80 hours/month of work, job training, education, or community service — or qualifying monthly income.
Targets many ACA Medicaid expansion adults (19–64); non-expansion states largely have no such group.
Federal enforcement: January 1, 2027 (states implement; some earlier).
New: expansion adults redetermine every 6 months (not annually).
Commonly-defined exemptions: pregnancy/postpartum; medically frail; primary caregiver; disability; SUD treatment; certain students; tribe (AIAN); short-term hardship. Exact definitions set by CMS rule and each state.

Short-term hardship exemptions to track

Short-term hardship exemptions — adoption pending state guidance.

Member communication risk

Risk detail pending.

What MCOs & state partners should do now

Segment affected members
Identify likely exemptions
Send plain-language multilingual notices
Deploy SMS/email/IVR reminders
Track retention outcomes

Operating in Pennsylvania?

The member-notice window is open now and closes August 31, 2026. Complete a Coverage Retention Readiness Audit while there is still time to act — we build CMS-compliant, plain-language, multilingual outreach to keep eligible Pennsylvania members enrolled.

Request a Coverage Retention Audit

Frequently asked

Who is subject to Medicaid work requirements in Pennsylvania?

Many ACA Medicaid expansion adults ages 19–64 who do not qualify for an exemption. Final scope is set by CMS rule and state implementation.

When do Pennsylvania Medicaid work requirements start?

Federal enforcement begins January 1, 2027 (some states may implement earlier). Member notices are expected in the federally-required window of June 30–August 31, 2026.

What exemptions are available?

Federal baseline categories include parent/caretaker of a child under 14, pregnant/postpartum, disabled/medically frail, American Indian/Alaska Native, and those already meeting SNAP/TANF work rules. Short-term hardship exemptions and exact definitions are set by CMS rule and state implementation.

Sources

This page tracks publicly available implementation information and is updated as Pennsylvania publishes guidance. State-specific rules are evolving. Not legal or eligibility advice.