A new federal law will introduce work or activity requirements for adults enrolled in Medicaid Expansion starting January 2027, alongside a shift to six-month coverage reviews. This change mandates that eligible individuals engage in work, volunteering, or educational/training programs for at least 80 hours per month to maintain their Medicaid Expansion coverage, unless they qualify for an exemption.
The requirement specifically targets Medicaid Expansion members aged 19 to 64, who have incomes below 138% of the federal poverty level and are not eligible for Medicare. Exemptions apply to several groups, including children, pregnant or postpartum individuals, adults with a disability, those over 65, individuals receiving Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), and parents or caregivers of young children or individuals with disabilities. Members will receive a notice by the end of September 2026 detailing these new requirements.
In other significant news for healthcare recipients, the Social Security Disability Insurance (SSDI) Disregard Program has been made permanent. This policy, which went into effect in Fall 2024 following legislation passed by the General Assembly, allows individuals receiving Developmental Disability Waiver services to retain their services even if their SSDI income exceeds previous limits. This ensures continued access to vital support for many Virginians.
Additionally, Governor Abigail Spanberger recently signed several key pieces of legislation. On June 11, the "Queen Candis Act" was enacted, a comprehensive package aimed at transforming sickle cell care in Virginia through improved education, training, access, and coordinated care. The Governor also signed bills on June 4 to enhance safety in hospitals and medical facilities by prohibiting firearms and dangerous weapons in mental health and developmental services facilities.
Finally, Cardinal Care reminds Central Virginia members that Open Enrollment for Virginia Cardinal Care closes on June 30. Individuals can enroll online, through the Cardinal Care app, or by calling 1-800-643-2273.