Community Living and Disability Rights: Why Recent Changes Matter

What You Need to Know: The Short Answer

Not everyone with Medicaid will be affected the same way. According to the Wisconsin Department of Health Services, these changes may impact between 60,000–200,000 Wisconsinites.

If you have Medicaid, don't assume you'll lose it. Many people won't have to meet the new work requirement because of their age, disability, health condition, pregnancy, or caregiving responsibilities.

What to do right now

You don't need to wait until 2027.

• Keep your contact information up to date (mailing address, phone, and email address) with your income maintenance agency.
• Read any notices you get about your BadgerCare Plus coverage in the mail or online.
• Set up an ACCESS account and get the MyACCESS app to see important notices.
• Opt-in to receive texts and emails. Log in to ACCESS (ACCESS in Spanish) and select Update Contact Information.
• Check our Medicaid News webpage for the latest information.
• Continue to use your BadgerCare Plus coverage to get the health care and services you need.

What Are the Changes and When Do They Start

Change 1: New limits for some immigrants (October 2026)

Starting October 1, 2026, some adults with immigration statuses that used to qualify for full Medicaid will no longer qualify.

This does not mean all immigrants lose Medicaid. Rules are different for children, pregnant people, emergency care, and different immigration statuses. Wisconsin still has programs that may cover people who can't get regular Medicaid because of immigration status.

These rules are complicated. Don't assume your situation is the same as someone else's.

More Information: Wisconsin DHS information about Medicaid coverage for noncitizens.

Change 2: Fewer months of retroactive coverage (January 2027)

Sometimes people don't know they qualify for Medicaid until after a hospital stay or emergency.

Right now, Medicaid can sometimes cover bills from up to three months before you applied. Starting January 1, 2027, federal rules shrink that window for new applicants; how much depends on which Medicaid category you're enrolled in. Ask your caseworker or benefits specialist how this applies to your situation.

Why this matters: If you think you might qualify for Medicaid, applying sooner will be even more important.

Change 3: The new work requirement (2027)

Who is affected? You may be affected if all of these are true:

• You're enrolled in BadgerCare Plus
• You're age 19 through 64
• You're not pregnant
• You're not the parent or guardian of a child under 19 who lives with you at least 40% of the time
• You don't qualify for another exemption

Who is likely NOT affected

You probably won't have to meet the work requirement if you are:

• Under 19 or 65 and older
• Pregnant
• A parent or caretaker of a child under 19
• Living with a qualifying disability or disability determination
• Already getting SSI or SSDI
• In another exempt group

You don't need a Social Security disability decision for a health condition to count. Wisconsin DHS has a screening tool to help you check.

More Information: Wisconsin DHS information about the Medicaid work requirement.

When it starts

New applicants: January 1, 2027. If it applies to you, you generally need to show you met the requirement in the month before you apply.

Current members: The earliest most current members will be affected is at a renewal starting in March 2027.

You may hear this called an "80-hour monthly work requirement." That makes it sound like you must report 80 hours every month. That's not how Wisconsin currently plans to check it for most current members.

If you're already enrolled, you generally only need to show you met the requirement in one month since your last approval—not every month. The state will check again at your next renewal.

What counts toward the requirement

You may be able to meet it by:

• Working
• Volunteering
• Doing an approved work or training program
• Going to school (at least half-time)
• Combining different activities
• Earning enough money

Wisconsin DHS currently says earning at least $580 in a month can meet the requirement. That's based on 80 hours at the federal minimum wage and could change. Always check the current rule.

What if you have a disability or health condition?

Don't assume you have to meet the work requirement. Wisconsin DHS says people with certain disabilities or serious medical conditions may be excused. You don't need to already get SSDI or SSI for a health condition to matter.

If you get a notice about the work requirement and you have a health condition, review the notice, check the DHS exemption information, and give your income maintenance agency any information they ask for. Asking questions early can prevent losing coverage.

What if you work but your hours change?

Variable hours don't automatically mean you'll lose Medicaid. For current members, Wisconsin plans to look for one qualifying month since your last approval, not 80 hours every month.

If you get a notice asking for information, respond—even if you think the state already knows you're working.

What happens if you don't meet it

If the requirement applies to you and you don't meet it or qualify for an exemption, your BadgerCare Plus may end at renewal. If you're applying, your application may be denied. You can apply again if your situation changes.

One more warning: If you lose Medicaid because you didn't meet the work requirement, you can still buy a Marketplace plan, but you may not get the tax credits that make it affordable. That's why it's important to identify an exemption if one applies.

Where to get help

Public benefits rules can be confusing, especially when you're working or thinking about working. ERI's benefits specialists help people understand how work and earnings affect Medicaid, Social Security disability benefits, and other supports.

A benefits specialist can help you see the whole picture, so you don't make a work decision based on just one benefit.

Learn more about ERI's benefits counseling.

Official information

Medicaid rules can change. Check Wisconsin DHS for the most current information.

• Wisconsin DHS: New Federal Medicaid Work Requirement
• Wisconsin DHS: Federal Medicaid and FoodShare Changes
• Federal Medicaid: Community Engagement Requirements

This is general information, not an individual Medicaid eligibility decision. Rules may change. Contact your local income maintenance agency or a qualified benefits specialist about your situation.