All states Virginia
Virginia Medicaid and the new work rules
Cardinal Care is run by Virginia Department of Medical Assistance Services (DMAS). Virginia expanded Medicaid on January 1, 2019, 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 636,000 people in Virginia. 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.
DMAS distinguishes three categories: 'exclusions' (checked once, at application or renewal, e.g. being a parent of a young child), 'exceptions' (checked across a rolling six-month lookback, e.g. being medically frail), and 'qualifying activities' (80 hours a month of combined work, job training, community service or education; OR half-time school enrollment; OR household income at or above $580/month, with six-month averaging allowed for people with seasonal or fluctuating work).
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.
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
- $1,800
- 2 people
- $2,433
- 3 people
- $3,066
Parents and caretakers138% of the poverty line
- 1 person
- $1,800
- 2 people
- $2,433
- 3 people
- $3,066
Pregnant143% of the poverty line
- 1 person
- $1,866
- 2 people
- $2,522
Source: Cover Virginia / DMAS published monthly income chart for MAGI adults, effective January 13, 2026.
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.
Virginia has a law that would end expansion automatically
Coverage here is tied by statute to how much the federal government pays.
2026 Appropriation Act (HB 30, Enrolled, Chapter 1), Item 291 ¶I.1–I.2 — identical operative language has appeared in every biennial budget since the 2018 expansion vote, most recently the 2025 budget's Item 288 ¶J.1–J.2. It is budget-bill language, not codified in the Code of Virginia (Va. Code § 32.1-325, Virginia's Medicaid statute, contains no trigger language). "In the event that the increased federal medical assistance percentages for newly eligible individuals included in 42 U.S.C. § 1396d(y)(1)[2010] of the PPACA are modified through federal law or regulation from the methodology in effect on January 1, 2014, resulting in a reduction in federal medical assistance as determined by the department in consultation with the Department of Planning and Budget, the Department of Medical Assistance Services shall disenroll and eliminate coverage for individuals who obtained coverage through 42 U.S.C. § 1396d(y)(1) [2010] of the PPACA. The disenrollment process shall include written notification to affected Medicaid beneficiaries, Medicaid managed care plans, and other providers that coverage will cease as soon as allowable under federal law following the date the department is notified of a reduction in Federal Medical Assistance Percentage.".
Press coverage shorthand describes this as firing if the federal match drops below 90%, but the statutory text is broader: it fires on ANY modification 'from the methodology in effect on January 1, 2014' that reduces federal medical assistance, which could in theory be triggered by a financing-structure change (such as a per-capita cap) even without an explicit rate cut below 90%. There is no legislative review step — DMAS disenrolls and ends coverage for the roughly 636,000-person expansion group as soon as administratively and federally allowable, with written notice to beneficiaries, MCOs and providers, but no required waiting period for the General Assembly to act first.
Unchanged and intact. The identical automatic-disenrollment language carried through the 2025 budget (HB 1600, Item 288) into the current 2026 budget (HB 30, Item 291), covering fiscal years 2027–2028. Gov. Youngkin's budget separately added a requirement that the Department of Planning and Budget deliver a fiscal-impact estimate within 30 days of any federal grant cut exceeding $100 million and that the governor consult legislative leaders about a special session — but that provision does not name Medicaid specifically and does not prevent or delay disenrollment under Item 291.
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: 1-800-817-6608 (TTY, Cardinal Care Managed Care Enrollment Broker).
Free interpreter line: 1-833-522-5582 (interpreter services available through the main Cover Virginia line).
Cover Virginia provides interpreter services by phone in many languages at no cost, and CommonHelp applications are available in English and Spanish online, with other languages available by phone or at a local department of social services. Ask for an interpreter when you call if English is not your first language.
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 Virginia?
How many hours a month do I have to work?
Who is exempt from the work requirement in Virginia?
When do the Virginia work rules start?
What is the income limit for Virginia Medicaid?
How do I apply for Cardinal Care?
How often do I have to renew Virginia 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.
Virginia's roughly 636,000-person Medicaid expansion group sits behind a budget-bill trigger law that automatically ends their coverage — with no required legislative review — if the federal government changes how it calculates the match rate from the formula in place on January 1, 2014.
A 2025 effort to replace that automatic cutoff with a 45-day legislative review process was dropped from the final budget, so the automatic trigger is still in force today. Separately, the work requirement starts January 1, 2027 with renewals moving from yearly to every six months, so expect an outreach letter from DMAS before the end of 2026.
Updating your address takes two minutes and protects everything else. Do that first, then check the exemption list above.
Go to CommonHelp (commonhelp.virginia.gov) →