New Medi-Cal requirements begin in 2027

Beginning Jan. 1, 2027, new federal requirements related to work, community engagement and coverage renewal will impact some Medi-Cal recipients.

Adults ages 19 through 64 who receive Medi-Cal through the Affordable Care Act (ACA) expansion — known as the New Adult Group — will need to meet Work and Community Engagement Requirements (WCER). These members will also be required to have their Medi-Cal eligibility reviewed more often.

Not all Medi-Cal members will be affected. The California Department of Health Care Services (DHCS) is in the process of sending information to members who may be impacted.

Impacted members will be required to work at least 80 hours per month, or an equivalent alternative. Accepted options include:

• Working, including paid, self-employed or in-kind work, for at least 80 hours a month
• Volunteering or completing community service for at least 80 hours a month
• Participating in a qualifying work or job-training program for at least 80 hours a month
• Attending school at least half-time
• Having a monthly income of at least $580 (80 hours at the federal minimum wage)
• Combining any of the above activities to reach 80 hours a month
• Additional options may apply to seasonal workers or people whose income or work hours fluctuate.

Some members can be excused from the new work requirements. Examples include:

• People who are pregnant or receiving postpartum care
• Parents or caretakers of children age 13 or younger
• People with medical conditions or disabilities that prevent them from meeting requirements.
• People with Medicare coverage
• American Indian or Alaska Native status
• Certain former foster youth younger than age 26

San Bernardino County has said they will work with Medi-Cal members to review available information and determine whether members must meet work requirements or qualify to be excused. If more information needs to be submitted, the county will provide further instructions explaining what to provide and when it is due.

Affected members will also have their Medi-Cal eligibility reviewed every six months instead of once a year. Being excused from the work requirement does not automatically mean a member is excused from six-month renewals.

Medi-Cal members are encouraged to contact their local Medi-Cal office if they have questions or need help responding. For the latest updates, visit the San Bernardino County Transitional Assistance and DHCS websites.