Overview
On July 4, 2025, a new federal law called the One Big Beautiful Bill Act (OB3) was signed. This law changes some Medicaid rules in DC.
Who Must Follow These Rules?
Starting in January 2027, new work requirements will apply strictly to the Childless Adults Medicaid group. If you are between the ages of 19 and 64 and do not have dependent children, you are in this group and must meet these requirements unless you qualify for an exemption.
How to Meet Medicaid Work Requirements
To receive or continue your Medicaid benefits, you must complete 80 hours of approved activities in a certain month. However, you do not have to follow this rule if you qualify for an exemption.
You can meet this requirement in any of the following ways:
- Income: You have at least $580.00 in total income (this can be earned from a job or unearned income like unemployment).
- Seasonal Workers: You qualify if your monthly income averaged at least $580.00 over the past 6 months.
- Employment: You work at least 80 hours in a full-time, part-time, or self-employed job.
- Community Service or Volunteering: You do unpaid work for at least 80 hours for a non-profit, religious group, or government agency.
- Job Training: You participate for at least 80 hours in a program that helps you find a job or learn new work skills.
- Education: You go to a school, college, or trade program at least half-time. This usually means taking at least 6 credits per semester.
- A Mix of Activities: You can combine different activities to reach your 80-hour total (for example: 40 hours of part-time work plus 40 hours of volunteering).
Exemptions from Medicaid Work Requirements
You may be excused from the 80-hour monthly work requirement if you qualify for an exemption (a reason you couldn't work). If you qualify for Medicaid work requirements and an exemption applies to you, you can keep your DC Medicaid coverage without having to work, volunteer or participate in job training. You can meet an exemption in any of the following ways:
- Medicare: You already get Medicare, or you are allowed to sign up for it.
- Jail or Prison: You are in jail or prison now, or you got out in the past 3 months.
- Former Foster Care Youth: You were in foster care in any state when you turned 18 and are currently under 26 years old.
- Native American or Alaska Native: You belong to a tribe that is recognized by the government.
- Parents and Caregivers: You take care of a child who is 13 or younger. Or you take care of a person with a disability. You help them often, not just once in a while. The person you help does not need to get disability checks for it to count.
- A Veteran: You are a veteran with a 100% disability rating.
- Medically Frail / Health Problems: You have a physical illness, mental health issue, or disability. This includes trouble with drugs or alcohol. This health problem must keep you from working, going to school, or volunteering.
- Already Meeting Other Rules: You are already following the work rules for SNAP (food stamps) or TANF (cash help).
- In Treatment: You are currently in a program that helps you recover from drug or alcohol use.
- Current or Recent Pregnancy: You are pregnant right now, or your pregnancy ended within the past year.
Additional Reasons to be excused from Medicaid Work Requirements
You may receive a short-term exemption from Medicaid work requirements if:
- You recently had an inpatient hospital stay;
- You recently lived in a nursing facility; or
- You had to leave your local area for a long time to get special medical care that you couldn't get close to home.
Next Steps
Starting January 1, 2027
For New Applicants and New Household Members
If you apply for Medicaid or add a new person to your existing coverage on or after January 1, 2027, applicants must show they completed 80 hours of work or other activities in the month immediately before applying.
Starting March 1, 2027
For Current Members
If you already have Medicaid, these rules will apply to you starting with renewals due on and after March 2027.
- Proof of Work Requirements: At your renewal, you must have worked, gone to school, or volunteered for at least one month during your previous renewal period.
- Shorter Renewal Period: Medicaid coverage will now be renewed every 6 months instead of every 12 months.
- Medicaid Retroactive Coverage: DHCF’s ability to cover medical bills from before your month of application will change from 3 months to either 2 months or 1 month. Starting in Fall 2026, members are encouraged to submit renewals timely to avoid coverage lapses.
Resources
- Work Opportunities: DC Works (opens in a new window) and Department of Employment Services (DOES) (opens in a new window)
- Volunteer Opportunities: Serve DC (opens in a new window)
- Education: Office of the State Superintendent of Education (OSSE) College Resource (opens in a new window) and DC Area College/University and Community College (PDF, opens in a new window)
Connect With Us!
- Take Action on Your Coverage or Contact Information Online: Log in to District Direct at districtdirect.dc.gov (opens in a new window) or through the Mobile Application to check your contact information we have on file or make other changes to your information and benefits. We encourage you to update your contact information if it is incorrect.
- Call Us: Contact the District Direct Call Center at 202-727-5355
- In-Person: Visit any service center near you. See locations below:
- Anacostia 2100 Martin Luther King Ave, SE
- Congress Heights 4049 South Capitol Street, SW
- Fort Davis 3851 Alabama Avenue, SE
- H Street 645 H Street NE
- Taylor Street 1207 Taylor Street NW
Frequently Asked Questions
Who is required to meet the new Medicaid Work Requirements?
These requirements apply strictly to childless adults aged 19–64 (adults with no dependent children).
You are exempt if you are:
- Under 19 years old
- 65 years or older
Will I have to renew my Medicaid more often?
Every 6 months: Yes. Starting in 2027, most adults must renew their Medicaid twice a year instead of just once a year.
Will I get anything in the mail letting me know if I will have to meet work requirements?
Yes. DC Medicaid will mail you several official notices before the rules officially change. You will receive communications at three distinct times:
- September 2026 (General Information Notice): DC Medicaid will mail a general informational letter to all active Medicaid recipients who may be subject to the work requirements to explain the upcoming changes.
- 120 Days (4 Months) Before Your Renewal Date (Early Reminder Notice): You will receive a letter to encourage you to start a qualifying activity if you have not already done so and do not have an exemption. (Note: You do not need to officially report anything to the state at this stage.)
- 60 Days (2 Months) Before Your Renewal Ends (The Renewal Packet & Reporting Notice): This is when official reporting happens. DC Medicaid will first attempt to automatically renew your coverage using electronic data. If they cannot verify your information, they will mail you detailed instructions alongside your official Renewal Form and Work Rules Form for you to fill out and return.
How do I show proof of my activity or exemption?
When your regular renewal comes due on or after March 2027, DC Medicaid will first attempt to verify your status automatically using electronic data. If we cannot verify your information, we will mail you two documents: a Renewal Form and a Work Rules Form. You must fill out, sign, and return both forms along with any required proof:
- For Most Exemptions (Self-Declaration): For categories like pregnancy, caregiving, medically frail or short-term hardships, you generally do not need to mail in physical documents. You can simply declare the exemption by checking the boxes on the forms and signing your name under penalty of perjury.
- For Activities and Certain Exemptions (Verification Required): You must mail or upload official proof if you are reporting:
- Income (paystubs, tax forms, award letter)
- Community service or volunteer hours (signed log sheets)
- Job training program enrollment
- VA disability status (VA rating letter)
I am 60 and retired, but no longer working. Will I have to comply with the work requirements?
Yes, unless you qualify for an exemption or meet the income threshold. Because the work requirements apply to adults up to age 64, being retired does not automatically excuse you.
However, you will not have to complete work hours if you meet any of the following:
- Income: You receive at least $580 a month in gross retirement benefits (such as Social Security, a pension, or 401k distributions).
- Medicare: You are already enrolled in Medicare.
- Health Status: You qualify as "Medically Frail" due to a physical or mental health condition that limits your ability to work.
Please review our Exemptions from Medicaid Requirements section above to see if another category applies to your situation.
If I am a parent, or if I take care of a child or someone with a disability, do I still have to meet the work requirements?
It depends on your exact caregiving situation. Here is how DC Medicaid evaluates these roles:
- Parents with Children on their Case: If you have a dependent child listed on your active Medicaid case, you are not considered a "childless adult." These work requirements do not apply to you at all.
- Caregivers for a Disabled Person or a Child: If you provide regular care for a child under 14 or a person of any age with a disability—regardless of whether they live inside or outside your home—DC Medicaid will need more details to confirm your exemption.
What you need to do: When you receive your Renewal Form and Work Rules Forms in the mail later in 2027 (based on your specific renewal month), you will be able to answer questions about your caregiving setup. Simply fill out those sections, sign the forms, and return them so the state can officially approve your exemption.