Medicaid Changes in 2027: What You Need to Know

New federal rules start in 2027 for some adults. Find out what’s changing in your state and what to do now.

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What’s changing, and who it affects

Federal Medicaid rules are changing. Starting in 2027, some adults may need to meet new requirements to keep their coverage. The changes do not apply to everyone. They mainly affect adults ages 19 to 64 who are enrolled through Medicaid expansion, and many people who are affected may qualify for an exemption.

The rules and dates are different in each state. Your state Medicaid agency decides whether a rule applies to you and whether you qualify for an exemption.

Animo Sano Psychiatry cannot decide Medicaid eligibility or exemptions. We can share official links and talk through care options if your coverage changes.

What should you do now?

These four steps help in every state.

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Keep your information updated

Make sure your state Medicaid agency has your current address, phone number, and email.

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Watch for messages

Watch for mail, email, and texts from your state Medicaid agency.

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Read and respond

Open every notice and respond by the deadline shown.

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Find your state below

Find your state below for dates and official links.

Medicaid information by state

Choose your state to see when changes start, who may be affected, and where to find official information.

* For the federal overview, visit medicaid.gov/renew-info. It explains the new requirement and lets you choose your state.

When are changes taking effect?

January 2027.

Who may be affected?

Certain adults ages 19 to 64 who get AHCCCS through Medicaid expansion and do not qualify for an exemption.

What can you do now?
  • Keep your contact information current with AHCCCS on the Health-e-Arizona Plus website.
  • Check your mail every week. Open all mail from AHCCCS or the Department of Economic Security.
  • AHCCCS has not yet published how to report activities or claim an exemption. Check its page for updates.

Questions? Call AHCCCS at 602-417-4000 or 1-800-654-8713.

Official information:

AHCCCS: H.R. 1 Overview and FAQ

Last reviewed: October 2026

When are changes taking effect?

A soft start began July 1, 2026. No penalties apply in 2026. The full requirement begins January 1, 2027.

Who may be affected?

Certain adults ages 19 to 64 who get Medicaid through ARHOME.

What can you do now?
  • Open any notice from Arkansas DHS about your status.
  • Keep your contact information current with Arkansas DHS.
  • Follow the reporting instructions in your notice. Arkansas uses the Access Arkansas portal for reporting.

Last reviewed: October 2026

Official information:

Arkansas DHS: ARHOME Community Engagement and Work Requirement

When are changes taking effect?

January 1, 2027. Current Pathways members are not affected until their renewal in 2027.

Who may be affected?

Pathways members and applicants ages 19 to 64.

What is changing?

Pathways already requires 80 hours a month of qualifying activities. Federal law changes how those rules work. Georgia lists a new option to qualify by earning at least $580 a month, updated exemptions, and changes to which activities count.

What can you do now?
  • Keep proof of your activities.
  • Make sure DFCS has your current address and phone number. Use Georgia Gateway or call 877-423-4746.
  • Applying for the first time? Georgia says to keep proof of your activities beginning December 2026.

Last reviewed: October 2026

Official information:

Georgia Pathways: H.R. 1 Changes to Pathways

When are changes taking effect?

January 1, 2027.

Who may be affected?

Certain adults ages 19 to 64 in the MO HealthNet Adult Expansion Group.

What can you do now?
  • Keep your mailing address, phone number, and email current with MO HealthNet..
  • Open mail and notifications as soon as you can.
  • Try Missouri’s screening tool. It gives an estimate only. The state makes the final decision.

En español:

Community engagement flyer

Official information:

Missouri DSS: H.R. 1 Participant Resources

Last reviewed: October 2026

When are changes taking effect?

January 1, 2027.

Who may be affected?

Some adults ages 19 to 64. New York lists many exemptions.

What can you do now?

Last reviewed: October 2026

Official information:

NY State of Health: Changes to Medicaid Coverage

When are changes taking effect?

January 1, 2027.

Who may be affected?

NC Medicaid says most adults ages 19 through 64 will need to meet the new requirement. Exemptions apply.

What can you do now?
  • Check that your local DSS has your address and phone number.
  • Answer any letter right away.
  • Start keeping proof, such as pay stubs, school records, or volunteer logs.
  • Get an enhanced ePASS account if you do not have one.

Questions? Call the NC Medicaid Contact Center at 888-245-0179.

Official information:

NC Medicaid: The Work and Community Engagement Requirement

En español:

El requisito laboral y de participación comunitaria

NC Medicaid plans we accept:

See our Medicaid page

Last reviewed: October 2026

When are changes taking effect?

January 1, 2027.

Who may be affected?

Expansion adults ages 19 to 64 who are not otherwise exempt. On August 31, 2026, the Oklahoma Health Care Authority (OHCA) mailed yellow notices to members likely to be affected.

What can you do now?
  • Check your phone number, address, and email at MySoonerCare.org.
  • Watch your mail and email for messages from SoonerCare or OHCA.
  • Got a yellow letter? Read it and follow its instructions.
How the check works:

OHCA first reviews the information it already has. If it needs more, it sends a notice. You then have 30 days to show you meet the requirement.

Last reviewed: October 2026

Official information:

OHCA: SoonerCare Work Requirements

The same page includes Spanish content and a screener. The screener gives an estimate only. OHCA makes the final decision.

Does the work requirement affect TennCare members?

TennCare says its members will not experience an impact from work or community engagement requirements. Tennessee does not have a Medicaid expansion adult group.

Do you need to do anything?

TennCare says you do not need to take any action to meet this requirement.

What still matters:
  • Keep responding to TennCare notices.
  • Report changes to your household or income.
  • Keep your contact information current at TennCare Connect or call 855-259-0701.

Other federal Medicaid changes may still affect some members. Check TennCare for updates.

Last reviewed: October 2026

Official information:

TennCare: Information about Community Engagement

If your coverage changes

If your Medicaid coverage changes or ends, you can still talk with us about your care.

Our billing team can:

  • Review the coverage information we have on file for you.
  • Explain self-pay rates and payment options.
  • Give you a Good Faith Estimate of what your care would cost.

Email VOB@animosanopsychiatry.com or call 919-391-7202.

Note: For questions about your treatment while coverage is being sorted out, contact your provider.

Do you want to Contact Us?

Check Your Coverage & Book an Appointment

Not sure if your Medicaid plan is accepted? Contact us today—our team will guide you through the process and help you schedule your first visit.

Your mental health matters. Get the care you deserve with Medicaid coverage at Animo Sano Psychiatry!

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