New Rules for Medicaid Coming Soon for Adults in the ACA Expansion Group
A new federal law, H.R. 1, as passed by Congress and signed into law by President Trump, adds new requirements for up to 320,000 Maryland Medicaid members. The Maryland Department of Health, Maryland Health Connection, our Managed Care Organizations and community partners are working together to help Maryland families navigate these new changes and stay covered.
What is the ACA Expansion Group
ACA Expansion Group is a Medicaid eligibility category created by the Affordable Care Act. It covers low-income adults ages 19 to 64 with household incomes up to 138% of the Federal Poverty Level. This group receives Medicaid through the State of Maryland’s marketplace through Maryland Health Connection.
What is changing for those in the ACA Expansion Group?
Starting Jan. 1, 2027, the federal government is requiring new rules for some adults to keep Medicaid coverage. These include:
- Show you are working or taking part in other activities (also called work requirements)
- Renew your Medicaid coverage twice a year
These changes are for adults who are 19 to 64 years old. This might affect you if you make up to $21,000 a year for one person, or up to $44,000 a year for a family of four.
These changes may NOT apply if you are:
- Younger than 19
- 65 or older
- Pregnant
- Disabled
- Caring for a young child
- Sick with a long-term health condition
When will this start?
The new federal rules begin in January 2027. When you renew your coverage next year, you will need to complete work requirements or other activities to keep your coverage.
Maryland Health Connection will send you a letter in September 2026 if you will need to meet work requirements when you renew your coverage in 2027
I’m in the ACA Medicaid Group, What Should I do?
Keep your contact information up to date in your account.
- If your address, phone number, or email changes, update it right away.
- Maryland Medicaid uses this information to send you important updates.
Report changes to your income or family in your account.
- You must report certain changes within 10 days.
- Some of these changes may affect whether you are subject to the new work requirements or a six-month renewal.
Open and read letters from Maryland Health Connection
Learn how to update your contact information or renew your coverage, see Renew Your Medicaid Coverage and Report Changes.
Need Help or Have A Question? Contact your Coordinator at The Coordinating Center.
Medicaid Check-In
- Medicaid Check-In: Learn what’s changing page. (Link opens new website)
- Medicaid Member Immigration Changes one-pager.(Link opens new website)
- Provider Immigration Changes FAQ document(Link opens new website)Â
- Work Requirements​​(Link opens new website)
- Healthy Babies Program(Link opens new website)
- Medicaid Check-In: Learn what’s changing(Link opens new website)
