All states Oregon
Oregon Medicaid and the new work rules
Oregon Health Plan (OHP) Plus is run by Oregon Health Authority (OHA), Health Systems Division — with eligibility and enrollment run by the Oregon Department of Human Services (ODHS) through the Oregon Eligibility (ONE) system. Oregon 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 . 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.
Oregon is leaning on automatic verification as hard as it can. OHA matches against SNAP and TANF work-registration records, Medicare and Social Security data, its own medical claims, and records for foster care and tribal status; it has also built a way for members to text a wage stub straight into the ONE eligibility system, and it checks compliance in at least one month out of the six months before your renewal date. New applicants are checked for the month before the month they apply. If Oregon cannot confirm from data that you comply or are excused, the renewal notice asks you for it — and OHA sends the renewal packet about 90 days before the due date.
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.
OHA told the Senate Health Care Committee in September 2026 that some national forecasts show more than 200,000 Oregonians who are otherwise eligible could lose Medicaid coverage over ten years because of the 2025 federal law. This is a forecast OHA cites rather than one it produced — the underlying work is Manatt Health's state-by-state analysis — and OHA was careful to say that true impacts will only be known over time. Separately, OHA estimates Oregon will lose about $12 billion in federal funding over ten years, and projects a $421 million General Fund deficit in 2027–29 and $868 million in 2029–31.
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.
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 64138% of the poverty line
- 1 person
- $1,836
- 2 people
- $2,489
- 3 people
- $3,142
- 4 people
- $3,795
- 5 people
- $4,449
- 6 people
- $5,102
- 7 people
- $5,755
- 8 people
- $6,408
Pregnant190% of the poverty line
- 1 person
- $2,527
- 2 people
- $3,427
- 3 people
- $4,326
- 4 people
- $5,225
- 5 people
- $6,125
- 6 people
- $7,024
- 7 people
- $7,923
- 8 people
- $8,823
Source: OAR 410-200-0315, Standards and Determining Income Eligibility (DMAP 7-2026, filed February 26, 2026, effective March 1, 2026), as published in Oregon Eligibility Partnership transmittal OEP-PT-26-005, "2026 Federal Poverty Level Income Standard Updates," issued February 5, 2026 and effective March 1, 2026. A note on precision: Oregon publishes two numbers for the same rule and both are correct. 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.
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.
About the phone numbers: The two main numbers do different jobs and keep different hours. Use 800-699-9075 for anything to do with applying, renewing or changing your address — it is open 7am to 6pm. Use 800-273-0557 only if you are already a member and something has gone wrong; it closes at 5pm. ODHS posts a standing warning that wait times at the Customer Service Center can be long, and suggests a local office or your online account instead. If you need help using your benefits rather than keeping them, your CCO is usually faster than either number.
Deaf, hard of hearing or speech-impaired: 711.
The OHP paper application is translated into sixteen languages besides English: Spanish, Russian, Vietnamese, Simplified and Traditional Chinese, Somali, Arabic, Farsi, Dari, Pashto, Korean, and five Pacific Islander languages — Kosraean, Palauan, Pohnpeian, Chuukese and Marshallese — which Oregon publishes because Compact of Free Association citizens qualify for full OHP benefits here. If your language is not on that list you can still apply: call 800-699-9075 and ask for an interpreter, or go to a local Department of Human Services office, where interpreters are provided at no cost to you. Large print, braille and other formats are also free on the same number, and every OHP line accepts relay calls. Oregon's work-rules fact sheets and the young-adult benefit materials come in a slightly different set that adds Hmong, Portuguese, Ukrainian and others, so it is worth asking for your language even if you do not see it listed.
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.
Provider supply here is around the national middle.
Book an appointment before you need one, not when you do.
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.
The requirement also reaches a separate waiver group here
Oregon is one of eight states CMS named for an extra 1115 waiver population.
Who that is. Young adults with special health care needs — a small group inside the Oregon Health Plan's section 1115 demonstration, known in Oregon as YSHCN, made up of people who had a serious long-term health condition before they turned 19 and who keep children's-level OHP benefits past their 19th birthday.
The new work rules were written for the ACA expansion group. But federal law also reaches adults covered through a section 1115 waiver that provides full coverage, and CMS went through every state's waivers looking for groups that resemble expansion adults. It named eight states that must apply the rules to specific waiver populations as well, and Oregon is one of them. Oregon's named group is the smallest kind imaginable: young adults who were already seriously ill or disabled as children, who would ordinarily drop off children's benefits at 19, and whom Oregon lets keep those benefits for a few more years so the handover to adult care does not break their treatment. Oregon's own waiver calls it Youth with Special Health Care Needs. You get in by having had a complex chronic condition, a serious emotional disturbance or serious mental health condition, an intellectual or developmental disability, or by answering yes to at least two of six screening questions about medication, frequent care, help with daily activities, counseling, therapies or medical equipment — and in every case the condition has to have started before you turned 19. The benefit is that you keep the full children's package: all medically necessary care under EPSDT, extra vision and dental, and help with housing, food and extreme-weather needs. Oregon reassesses the health criteria every two years. If this is how you are covered, the work rules can still reach you, because federal law looks at the waiver you are enrolled through and not at what your coverage is called.
Almost nothing about this coverage sounds like the expansion. It is a children's benefit package, it is named for special health care needs, the people in it qualified on grounds of illness or disability rather than income, and many of them have been on OHP continuously since childhood. A 20-year-old in this group has every reason to read the news about Medicaid work requirements and conclude it is about somebody else. Most people in it will in fact be excused, because Oregon's medical exemption is broad and the group is defined by having a serious long-term condition — but being excused is something you have to be found to be, which starts with opening the letter.
One thing here is not settled, and it is better to say so. Georgetown CCF reports that CMS has been working with at least some of the states whose named waiver groups are very small to see whether an exception might be allowed. Oregon is exactly the kind of case that describes, because the group is tiny and is largely made up of people who would be excused in any event. No decision has been published. One thing that was open has now been resolved. Oregon has a second live waiver authority that fits the same federal description — Expenditure Authority 11, the Expanded Adult Program for Individuals Exempt from Managed Care, covering adults 19 through 64 between 133% and 200% of the poverty line who are excused from mandatory managed care, which is the Medicaid half of OHP Bridge. CMS's own slide deck lists one Oregon population and not two: its Oregon row reads "Oregon Health Plan: Youth with Special Health Care Needs". So the second authority was not named, and the work rules do not reach it through this route.
If you are covered one of these ways rather than through the ordinary expansion group, the rules above still reach you. Don't assume otherwise because your coverage has a different name.
CMS interim final rule, 91 Fed. Reg. 33348, with the discussion of additional section 1115(a)(2) waiver populations at 33353–33354 (June 3, 2026); the CMS slide deck naming eight states and 13 demonstrations, posted to medicaid.gov on July 27, 2026 at medicaid.gov/medicaid/downloads/ce-requirement-ifc-deck.pdf and reported by Georgetown CCF on July 16, 2026 and by KFF on July 24, 2026; Oregon Health Plan 1115 demonstration 11-W-00415/10, Expenditure Authority 9 and Special Terms and Conditions 4.6, approval period October 1, 2022 through September 30, 2027, as amended October 16, 2024; OAR 410-200-0455 (DMAP 81-2025, effective January 1, 2026) and OAR 410-200-0315(9)
Questions people ask about this
Do the new Medicaid work rules apply to me in Oregon?
How many hours a month do I have to work?
Who is exempt from the work requirement in Oregon?
When do the Oregon work rules start?
What is the income limit for Oregon Medicaid?
How do I apply for Oregon Health Plan (OHP) Plus?
How often do I have to renew Oregon 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.
Oregon is mailing more than 600,000 OHP members a notice about the new work or activity rules right now, and that letter names your own next renewal date.
That date is the one that matters, because most OHP members only renew every two years and OHA says many people's first renewal under the new rules will not come until 2028 — so open the letter, and make sure OHP has your current address, phone and email, either at Benefits.Oregon.gov or on 800-699-9075.
Updating your address takes two minutes and protects everything else. Do that first, then check the exemption list above.
Go to ONE.Oregon.gov, Oregon's application system →