Medicaid Changes

WHAT YOU NEED TO KNOW

If you are an adult between the ages of 19 and 64 who has Medicaid coverage you need to know of important changes coming January 1, 2027.

THE KEY CHANGES IN JANUARY 2027

• Many adults ages 19 to 64 who are enrolled in Medicaid will need to complete 80 hours of work or activity requirements (like working, volunteering, or going to school at least half-time) in a month and report those activities at their renewal (unless they qualify for an exemption).
• If you are an adult applying for Medicaid for the first time, you may need to complete 80 work or activity hours during the month before you apply.
• Activity hours may include work, community service, a qualifying work program, school, or career training at least half-time, or other approved activity. Members can combine activities to total 80 activity hours.
• Many Medicaid members will have to renew their coverage every six months.
• Some lawfully present immigrants who are currently eligibile for Medicaid will no longer be covered.

WHO IT IMPACTS

Starting Jan. 1, 2027, new rule will apply to some Medicaid members ages 19 to 64. These changes do not apply to pregnant people, those who are already on Medicare Part A or B, or those eligible under other Medicaid categories (like people with disabilities, older adults 65+, or those caring for children under the age of 14) or those who qualify for another exemption.

Many adults may already be exempt from activity hours. This may include people who are

• Parent, guardian, caretaker relative or family caregiver of a dependent child under the age of 14 or a disabled individual
• Pregnant women or individuals entitle to postpartum medical assistance
• Entitled to Medicare Part A or enrolled in Medicare Part B
• Foster youth and former foster youth ages 18 up to 26
• American Indian / Alaska Natives
• Veterans with disability rated as total
• Medically frail individuals (blindness or disability, substance abuse disorder, mental disorder, significant physical or intellectual disability)
• Individuals who are participating in a substance use disorder or alcohol use disorder treatment program
• Individuals who are already in compliance with the work requirements under the TANF program or SNAP
• Individuals who are incarcerated or recently released from incarceration within the past 90 days
• Hospitalized or living in a nursing home or similar facility. This exemption must be requested by the individual.
• Individuals having to travel outside their community to receive medical services necessary to treat a serious or complex health condition that are not available in the community of residence.
• An individual living in a county under a federal emergency declaration OR with a high unemployment rate (85 or 1.5 times the national unemployment rate).

Other reasons you may NOT need to report work or activity requirements  

If any of these temporary reasons apply to you, you do NOT need to meet work and activity requirements until your next renewal: 

• Under the age of 19 or age 65 and older, 
• Enrolled in Medicare Part A or Medicare Part B,  
• Covered on another mandatory Medicaid category,  
• Released from a public institution (like a jail or prison) in the last 3 months,  
• You receive inpatient care, nursing facility services, intermediate facility care, or similar services, 
• You or a dependent must travel outside of your community for a long time to receive necessary medical services, 
• You live in a county that had a federally declared emergency or disaster, or 
• You live in a county with a high unemployment rate (as determined by the State). 

HOW TO REPORT YOUR WORK OR ACTIVITY HOURS  

There are many ways to meet the work or activities requirements. For a total of 80 hours each month, you can combine any of these activities: 

• Work, 
• Volunteer, 
• Attend school at least half-time (includes general educational development (GED), high school, college, and technical/vocational programs), 
• Participate in a work training program, 
• Be a seasonal worker with an average income of at least $580 over the last 6 months, or 
• Have monthly income of at least $580 each month. 

At your renewal, you may be asked to provide proof that you completed 80 hours of work or activities in any month since your last renewal. 

Keep proof of each month’s work or activity hours or your exemption. 

If work or activity hours apply to you and HCA cannot verify them, you will receive a notice of noncompliance and have 30 calendar days to respond. During that time, you have the opportunity to show that: 

• You completed your work or activity hours, 
• You qualify for an exemption, or 
• The rule does not apply to you. 

WHAT HAPPENS IF YOU DON’T REPORT WORK AND ACTIVITY HOURS? 

At your renewal, we will try to automatically confirm your eligibility. If we cannot confirm that you have met, or were exempt from, Medicaid work and activity requirements, you will receive a 30-day compliance notice. This gives you more time to complete activities or report why you do not need to comply.  

Your Medicaid coverage may end if you do not meet work and activity requirements at your renewal. 

IMMIGRATION CHANGES

Beginning on October 1, 2026 some lawfully present immigrants who are currently eligible for Medicaid will no longer be covered.

Only the following immigrants will be covered on Medicaid:

• Legal Permanent Residents (subject to the 5-year waiting period)
• Cuban / Haitian entrants
• COFA Migrants
• Lawfully residing children and pregnant women under the CHIRPA 214 option

New Mexico may be able to continue coverage for immigrants no longer eligible for Medicaid using only state funding.

Emergency Medical Services for Non-Citizens (EMSNC) will still be available.

HOW TO PREPARE FOR CHANGES

• Update your mailing address at YES.NM.GOV using the chat
• Watch for letters, renewal forms, and other notices from HCA
• Check whether activity hours apply to you or whether you qualify for an exemption
• Keep records of activity hours or your exemption
• Respond quickly if HCA asks for information

TIMELINE 

September 2026: Letters mailed to affected members 

Beginning Sept. 1, 2026, New Mexico Medicaid mail letters to members who must complete work or activity requirements to keep or receive Medicaid coverage. 

January 2027: Work and activity requirements and 6-month renewal notifications begin for some adult members 

In January, New Mexico Medicaid will mail letters to members with a March 2027 renewal date. If a member must comply with work or activity requirements, they may need to show proof of compliance or notify us of their exemption in order to keep their Medicaid coverage. 

WHERE TO GO FOR MORE HELP

• Use the Chat at YES.NM.GOV
• Call 1-800-283-4465
• Visit a local HCA Income Support Division office
• For Help Finding Work visit dws.state.nm.us 

For volunteer opportunities in the Albuquerque area, visit oneabqvolunteers.com 

Looking for more volunteer opportunities? Check the link to the –> New Mexico Volunteer Sites List for opportunities across the state. 

This optional form helps Able-Bodied Adult Without Dependents (ABAWDs) keep track of their volunteer hours. The person in charge of the volunteer work must sign it. You only need to submit this form when applying for your first grant, renewing it, or if your reported work hours are less than 20 hours per week. Link–> Volunteer Hours Verification Document