New work rules for health coverage start next year

Federal health care regulations requiring adults to log a specific number of work or community hours will begin affecting new applicants in San Bernardino County on January 1, 2027. These changes stem from H.R. 1, a federal law that introduces Work and Community Engagement Requirements for a specific subset of Medi-Cal recipients.

The rules target adults ages 19 through 64 who qualify for coverage under the Affordable Care Act expansion, a category known as the New Adult Group. While the new standards apply to this group, other Medi-Cal members will retain their current coverage structures and renewal schedules.

Under the new framework, impacted members must complete 80 hours of activity per month to maintain eligibility. This requirement can be met through paid or self-employed work, volunteering, or participation in job training programs. Attending school at least half-time also satisfies the monthly hour threshold.

Members can alternatively demonstrate eligibility by earning a monthly income of at least $580. This figure corresponds to 80 hours worked at the federal minimum wage. Individuals may also combine various activities, such as part-time work and volunteering, to reach the required total.

Several groups are exempt from the work mandate. These exemptions include pregnant individuals and those receiving postpartum care. Parents or caretakers of children age 13 or younger are also excused, as are people with medical conditions or disabilities that prevent them from meeting the hour requirement. Other exemptions apply to those with Medicare coverage, American Indian or Alaska Native individuals, and certain former foster youth under age 26.

In addition to the work requirements, affected members will face a change in how often their eligibility is reviewed. Instead of an annual check, these individuals will undergo a review every six months. For example, a member who completes a renewal in March 2027 will be required to undergo another review in September 2027. Being excused from the work requirement does not automatically remove the need for these six-month checks.

The California Department of Health Care Services began notifying potentially impacted members in February 2026 via text messages. Mailing outreach letters started in August 2026, with documents provided in multiple languages. San Bernardino County is also distributing this information to new and returning applicants through the end of the year.

County officials advise members to keep their contact information up to date and to monitor their mail and online accounts for notices. Responding to renewal forms and reporting changes in income or household circumstances by stated deadlines will help prevent interruptions in coverage. The county will work with members to verify whether they must meet the new standards or qualify for an exemption.

The state and local agencies plan to share further details regarding verification forms and specific timelines as guidance becomes available. San Bernardino County will continue coordinating with community partners and federal agencies to provide support to residents navigating these administrative changes.