Medi-Cal Overhaul: Federal Law Mandates Work Hours and Six-Month Renewals for Adults

The San Bernardino County Department of Public Health is urging Medi-Cal members to prepare for federal changes that will alter eligibility requirements and renewal schedules beginning in 2027. These changes stem from H.R. 1, a law that introduces Work and Community Engagement Requirements for adults ages 19 to 64 enrolled through the Affordable Care Act expansion.

The new rules will not apply to every Medi-Cal recipient. The California Department of Health Care Services is currently identifying which members fall into the affected New Adult Group. Those individuals will face stricter conditions for maintaining coverage, including a requirement to demonstrate consistent participation in work, education, or community service.

For new applicants, the evaluation process starts on Jan. 1, 2027. Current members will see the changes take effect in March 2027. The county will send notices to affected individuals explaining which requirements apply to them and whether additional documentation is necessary. Members who do not receive such a notice will generally continue under existing rules.

To remain eligible, affected members must meet one of several criteria each month. They can work at least 80 hours, which includes paid employment, self-employment, or in-kind work. Alternatively, they may volunteer or complete community service for 80 hours. Participation in a qualifying job-training program for 80 hours also satisfies the condition. Attending school at least half-time is another accepted option.

Members may also qualify by earning a monthly income of at least $580. This threshold corresponds to 80 hours of work at the federal minimum wage. Individuals can combine different activities to reach the 80-hour mark. Seasonal workers or those with fluctuating incomes may have additional options available. The county will review member data to determine if an individual meets the requirements or qualifies for an exemption.

Several groups are excused from the work requirement. These include pregnant individuals or those receiving postpartum care, as well as parents or caretakers of children age 13 or younger. People with medical conditions or disabilities that prevent them from meeting the requirements are also exempt. Other exclusions apply to those with Medicare, American Indian or Alaska Native status, and certain former foster youth under age 26. Being excused from work requirements does not necessarily exempt a member from more frequent eligibility reviews.

Renewal processes will become more frequent for the affected group. Instead of an annual review, these members will have their eligibility checked every six months. For instance, a member completing a renewal in March 2027 will face another review in September 2027. Other coverage groups will maintain their current renewal schedules. The county may use existing data to process renewals, but members must respond to any requests for additional information by the stated deadlines.

Outreach efforts began in February 2026 with a text message campaign from the state. Mailing letters to current New Adult Group members started in August 2026. These letters are available in multiple languages. San Bernardino County has also included information about the changes in application materials provided to new and returning members through the end of 2026.

To avoid interruptions in coverage, members should keep their mailing address, phone number, and email address current with the county. They should check their mail and online accounts regularly for notices. Members are advised to return renewal forms and requested information by the deadlines. They should also report any changes in income or household circumstances. The BenefitsCal website allows members to manage benefits, upload documents, and review notices. San Bernardino County will continue to share updates through its website and in coordination with state and federal agencies.