All states Ohio
Ohio Medicaid and the new work rules
Medicaid Expansion ("Group VIII" / MAGI Adult category — the casework name; not used in consumer materials) is run by Ohio Department of Medicaid (ODM). Ohio expanded Medicaid on January 1, 2014, which is why the new federal work requirement reaches this state — and why what you do before January 1, 2027 matters.
From January 1, 2027, most adults have to show 80 hours a month
The requirement applies to adults aged 19 to 64 covered through Medicaid expansion — around 631,184 people in Ohio. It is not only about paid work: study, job training, volunteering and a mix of them all count , and earning at least $580 a month satisfies it on its own.
ODM must perform a 'look-back' review of one to three months before a new application, and must verify at least one month of compliance within each six-month renewal period for existing enrollees, using existing data sources (ex parte) where possible. Someone ODM cannot verify through data gets a Group VIII Work and Community Engagement Verification Request and 30 days to respond before denial or disenrollment.
If your hours swing from month to month, say so. The rule is written per month, which is the wrong shape for farm and fishing work, construction, tourism and seasonal retail — a good month and a dead month average out to a living, but the dead month is the one that fails. Federal law has a provision for exactly this: a seasonal worker can satisfy the requirement using their average monthly income over the previous six months instead of hours worked in the month being checked. It is at 42 CFR 435.552(a)(7), and the law defines who counts as seasonal by pointing at the tax code rather than listing jobs, so do not decide for yourself that it misses you. If your work is seasonal or your hours are irregular, tell the state that when you report, and ask for the six-month average to be used.
That is the state's own estimate of how many will lose coverage.
ODM's own estimate of how many Ohioans will lose Medicaid eligibility over the SFY2026-27 biennium because of the requirement. An independent Urban Institute analysis of Ohio's state-level waiver application estimated a substantially higher figure, more than 200,000 — the two estimates are not measuring the same policy (ODM's figure is for the biennium under the current design; the Urban Institute figure was modeled against Ohio's 2025 state waiver application specifically), so both are reported here rather than reconciled.
Most of that is expected to be paperwork rather than people becoming ineligible. Which is the whole reason to sort out your address and your proof now rather than at the last minute.
You do not have to prove anything if any of these describe you
Exemptions are meant to be applied by the state automatically from records it already holds, but records are imperfect. If one of these fits you and you still get asked to report hours, say so and ask them to check — don't assume the notice is right.
Before you assume this applies to you the way you think
What you can earn and still qualify
Monthly income, before tax, for the whole household. These are the state's own published figures, which is what its caseworkers actually apply. If you are close to a line, apply anyway — some income does not count, and only the agency can run the calculation for your situation.
Adults 19 to 64133% of the poverty line
- 1 person
- $1,769
- 2 people
- $2,399
- 3 people
- $3,028
- 4 people
- $3,658
- 5 people
- $4,288
- 6 people
- $4,917
Parents and caretakers90% of the poverty line
- 1 person
- $1,197
- 2 people
- $1,623
- 3 people
- $2,049
- 4 people
- $2,475
- 5 people
- $2,901
- 6 people
- $3,327
Pregnant200% of the poverty line
- 1 person
- $2,660
- 2 people
- $3,607
- 3 people
- $4,554
- 4 people
- $5,500
- 5 people
- $6,447
- 6 people
- $7,394
Source: Ohio Department of Medicaid, Medicaid Eligibility Procedure Letter (MEPL) No. 194, 'Medicaid: 2026 Federal Poverty Level Income Guidelines,' issued January 21, 2026, effective March 1, 2026. A note on precision: Ohio does not vary the children's income limit by age band the way many states do — a single 156% FPL standard (with other creditable insurance) and 206% FPL standard (without) applies from birth through age 18 (OAC 5160:1-4-02). We publish the state figure.
Two other changes land on the same day
Renewals get more frequent, and back-dated coverage gets shorter.
P.L. 119-21 §71112, amending 42 U.S.C. §1396a(a)(34). Applies to applications submitted on or after January 1, 2027.
Ohio has a law that would end expansion automatically
Coverage here is tied by statute to how much the federal government pays.
Ohio Revised Code 5163.04, enacted by House Bill 96 (the FY2026-27 operating budget), effective September 30, 2025. If the federal medical assistance percentage for medical assistance provided to members of the expansion eligibility group is set below ninety per cent, the department of medicaid shall (1) immediately discontinue all medical assistance for members of the group, and (2) within fifteen business days certify the state and federal shares of expenditure for the group to the state budget director, the Legislative Service Commission, and the leaders of the Ohio Senate and House.
This ties continued coverage for everyone in Ohio's expansion group to a single federal funding percentage, with no transition period — coverage ends immediately, not 'as expeditiously as possible' or after a legislative review. Enhanced FMAP for the expansion population is currently 90%, so the trigger sits exactly at the floor: any federal reduction below 90% would end expansion coverage the same day.
In force since September 30, 2025 and not currently under legislative challenge that could be identified.
This is not a reason to delay applying. It is a reason to keep your contact details current, open everything the state sends, and not assume coverage renews itself.
Do this now
Update your address and phone number first. Everything about the new rules arrives by mail, and a stale address is the most common reason people lose coverage they are still entitled to. Then check whether an exemption applies to you.
Deaf, hard of hearing or speech-impaired: 711.
Ohio Medicaid materials and the Ohio Benefits Self-Service Portal are available in Spanish, and the state provides free interpreter and translation help in other languages on request through the county Job and Family Services office or the Ohio Medicaid Consumer Hotline at 1-800-324-8680. OhioRISE offers a dedicated language line at 1-833-711-0773 for behavioral health members. If you are more comfortable in a language other than English, ask for an interpreter when you call or apply — you do not need to bring your own.
Most people who lose coverage lose it over paperwork, not eligibility
Nationally, most people who lose Medicaid lose it over paperwork rather than because they stopped qualifying. From January 1, 2027 that matters more, not less.
NOTICE OF ELIGIBILITY DETERMINATION
Case number: ███████
Date of this notice: 1January 12, 2027
Our records do not show that you met the community engagement requirement for the reporting period.
2If you believe this is incorrect, or if an exemption applies to you, contact us on or before February 11, 2027.
3Coverage for other members of your household is not affected by this notice.
What the federal data says about coverage here
Public federal data describes how each state runs its program. Almost all of it is written for policy analysts. Here is what those numbers mean if you are the person enrolled.
Coverage here runs through private health plans rather than the state paying providers directly. You pick a plan, and your plan decides your network.
Check your doctor is in the plan before you choose it.
Questions people ask about this
Do the new Medicaid work rules apply to me in Ohio?
How many hours a month do I have to work?
Who is exempt from the work requirement in Ohio?
When do the Ohio work rules start?
What is the income limit for Ohio Medicaid?
How do I apply for Medicaid Expansion ("Group VIII" / MAGI Adult category — the casework name; not used in consumer materials)?
How often do I have to renew Ohio Medicaid?
Guides for neighboring states
The rules change completely at the state line. If you moved recently, or you're helping family somewhere else, start with their state rather than this one.
If you are covered through Ohio's Medicaid expansion group, your coverage currently depends on a 133% federal poverty level test plus a separate 5% income add-on that Ohio applies but does not advertise in the headline number — so do not assume you are over the limit just because your income looks close to the published figure.
The bigger change is coming January 1, 2027, when a federal work and community engagement requirement takes effect alongside renewals moving from once a year to every six months; Ohio has already said it expects about 62,000 people to lose coverage over the next two years, mostly for paperwork reasons rather than actual ineligibility, so responding quickly to any notice from Ohio Benefits between now and then matters more than usual.
Updating your address takes two minutes and protects everything else. Do that first, then check the exemption list above.
Go to Ohio Benefits Self-Service Portal (ssp.benefits.ohio.gov) →