The requirements begin in 2027
Starting Jan. 1, 2027, many Medicaid members ages 19 to 64 will have to complete at least 80 hours a month of work, school or volunteering and report those activities to maintain coverage. The rules stem from the One Big Beautiful Bill Act, signed into law last year, according to the New Mexico Health Care Authority.
Some adults subject to the requirements will also have to renew Medicaid every six months instead of every year. The Health Care Authority projects that the more frequent checks could lead to about 101,760 enrollees losing coverage for at least two months, Searchlight New Mexico reported.
Caregiver exemptions depend on the circumstances
The state lists caregivers of a child under 14 and caregivers of a person with a disability among those who may qualify for an exemption. Other listed groups include pregnant or postpartum people, veterans with a 100% disability rating, former foster youth under 26, American Indian or Alaska Native people, people required to meet TANF or SNAP work rules, people in jail or prison, people in drug or alcohol treatment, and medically frail people or those with special medical needs, according to the Health Care Authority.
The Health Care Authority said it plans to use existing relationship information and self-attestations in 2027 to assess caregivers’ efforts and exemptions, according to The Santa Fe New Mexican. The agency has also mailed turquoise envelopes to Medicaid customers seeking information about the changes; more than 230,000 customers received letters in early September, Searchlight New Mexico reported.
Estimates point to substantial coverage losses
The Health Care Authority estimates that the work and community-engagement rules could result in about 89,000 people losing coverage statewide, according to Searchlight New Mexico. New Mexico Medicaid Director Dana Flannery gave a separate estimate of approximately 88,000 losses from work requirements alone, Source New Mexico reported. The supplied reporting does not explain whether the estimates use different methods or assumptions, so they should not be treated as directly comparable.
