State tracker

West Virginia — Medicaid Coverage Retention

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

West Virginia 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: West Virginia Purchasing Division / wvOASIS (state.wv.us/admin/purchase, wvOASIS.gov) for statewide solicitations; DHHR Bureau for Medical Services posts agency-specific Medicaid procurement notices at wvdhhr.org/dhhrRFP.asp. No SAM.gov listing required (state-funded/administered). · Implementation funding: No state-specific implementation budget figure confirmed. Federally, H.R.1 appropriated $200M to CMS in FY2026 plus $200M distributed to states for community-engagement implementation; WV's specific share/allocation and any state general-revenue request were not publicly disclosed in available sources. WV HB 4027 (2026 session budget bill) increased Medicaid general-revenue funds but is not tied to a specific work-requirements procurement line. Pending.

Latest detail

Work requirements take effect Jan 1, 2027 for the ~161,000-person Medicaid expansion population (ages 19-64), requiring 80 hours/month of work, training, school, or community service; required member outreach must begin by June 30, 2026. The WV Department of Human Services (which now runs Medicaid after the 2024 DHHR split) enlisted West Virginia University (WVU) Health Affairs to help with project management and systems requirements rather than issuing a competitive RFP for that work; officials say the state may need to upgrade eligibility systems and hire additional staff. An April 2026 Health Management Academy survey found about 55% of WV Medicaid recipients were unaware the requirements are coming, and the Department of Human Services declined to answer press questions in late May 2026, leaving any communications/outreach vendor strategy publicly undisclosed.

Medicaid expansion status	Expanded
Implementation status	Planning/preparing for Jan 1, 2027 federal deadline; DoHS partnering with WVU Health Affairs on systems and project management
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 West Virginia?

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 West Virginia members enrolled.

Request a Coverage Retention Audit

Frequently asked

Who is subject to Medicaid work requirements in West Virginia?

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 West Virginia 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 West Virginia publishes guidance. State-specific rules are evolving. Not legal or eligibility advice.