The Idaho Department of Health and Welfare (DHW) is issuing this update about the implementation of new reporting requirements for the state’s Medicaid expansion population, effective Jan. 1, 2027.

Last year, H.R. 1 was approved by the U.S. Congress and President Trump, directing states to implement new work requirements for Medicaid recipients in the expansion category to qualify for Medicaid and keep their coverage. These changes require Medicaid expansion enrollees to report on their participation in work or community engagement activities.

Key policy changes and requirements:

• 80-hour work requirement: Enrollees are required to document at least 80 hours per month of employment, community service, or approved educational/training activities.
• Three-month look-back period: Applicants must comply with the work requirement for three months before they can be approved for Medicaid enrollment.
• Semi-annual renewal: Recipients must meet eligibility requirements and verify their work history or community service participation twice a year in accordance with federal enrollment renewal timelines.

The new work requirements

• Working (or earning at least $580 a month)
• Participating in a work program
• Doing volunteer or community service
• Participating in certain job training programs
• Participating in an educational program (such as college, technical programs, high school or GED programs)
• A combination of the above activities

Exemptions: Recognizing that some Idahoans are unable to work, state and federal guidelines allow for specific exemptions. The new work requirement may not impact Medicaid customers if any of these apply:

• You are pregnant, now or within the last 12 months
• You are a parent or other relative who is the main caregiver of a child age 13 or younger
• You are a caregiver of a person with a disability
• You have a physical, mental, or developmental disability that makes it hard to do daily activities
• You have a serious or complex health condition that requires regular medical care
• You have a substance use disorder, or are in a drug or alcohol treatment program
• You have a disabling mental health condition (such as schizophrenia, major depression, or OCD)
• You are blind
• You are 18-25 and aged out of foster care
• You are an American Indian or Alaska Native
• You are a veteran with a 100% disability rating
• You are currently incarcerated, or were released from incarceration within the last 90 days
• You get SNAP (food benefits) or TANF (cash assistance), and are already required to meet work requirements for those programs

Next steps for recipients DHW is sending letters to all households affected by these changes and will continue to communicate updates to recipients through a variety of methods in the coming weeks and months.

To ensure that recipients receive important program information, they should ensure their mailing address, phone, and email are up-to-date and sign up for email and text alerts in addition to mailed notices online at the Idalink portal. Idahoans can verify their enrollment status by calling 1-877-456-1233.

DHW will host virtual town halls for community members in the coming months. For more information about the new requirements, visit the Medicaid website and the DHW website about Medicaid expansion.