Medicaid Updates

New federal laws will stop Medicaid for some people who are not U.S. citizens. Starting October 1, 2026, only the following groups of non-citizens will be eligible for Medicaid: 

• Lawfully permanent residents (after the five-year waiting period); 
• Cuban/Haitian entrants; 
• COFA migrants (i.e. people from Micronesia, the Marshall Islands, and Palu); and 
• Children and pregnant people. 

If your immigration status recently changed to one of these groups, please update your account information so your Medicaid coverage can continue.

Medicaid will continue to cover emergency care regardless of immigration status.

If this new federal law will affect your Medicaid, the State will let you know before it goes into effect. You will get a notice from the State of Rhode Island in your HealthyRhode account. If you’ve signed up to receive paper notices, you will also get a copy sent to you in the mail.

The notice will have information about other ways to get healthcare. It will also have information about how to file an appeal if you disagree with any decision the State makes about your Medicaid coverage. 

Due to new federal laws, some Medicaid members will need to meet community engagement requirements starting January 1, 2027. These rules are sometimes called “work requirements,” but they include more than just employment. 

Who will have to complete community engagement requirements?

New federal community engagement requirements for Medicaid may apply to you if you are age 19-64 and get Medicaid through the Medicaid expansion program (sometimes called “expansion adults”).

The expansion program, or “expansion adults”, typically refers to adults between ages 19-64 who are not pregnant, are not a parent/caretaker of a minor child, and do not have Medicare.

Community engagement requirements may not apply to you if you are: 

• Younger than 19 or older than 64; 
• A parent or primary caregiver of a child younger than14;
• A parent or guardian of a person of any age with a disability; 
• Medically frail;
• Participating in a drug or alcohol treatment program; 
• Pregnant;
• Within 12 months post-partum;
• Native American; 
• Currently incarcerated ;
• A former inmate of a public institution within the last three months; 
• A former foster care child younger than 26;
• A veteran with a total disability rating;
• Already compliant with TANF work requirements; or
• Receiving SNAP and not exempt from SNAP work requirements.

How can I meet the community engagement requirements?

Under federal community engagement requirements, members must complete 80 hours of work, education, job training, and/or community service to stay on Medicaid. Members will only have to show proof of their compliance for a specific time period before application or before renewal.  

If you are not exempt, you can meet the community engagement requirements by:  

• Completing 80 hours of work, community service, or work program participation;  
• Being enrolled in an educational program at least half-time (40 hours);  
• Having a monthly income of no less than $580 (the monthly income equivalent to at least federal minimum wage for 80 hours); or  
• For seasonal workers only, having an average monthly income over the preceding six months that is not less than $580. 

If this new federal law will affect your Medicaid, the State will let you know before it goes into effect. You will get a notice from the State of Rhode Island in your HealthyRhode account. If you’ve signed up to receive paper notices, you will also get a copy sent to you in the mail. 

The notice will have information about work, volunteer, or education opportunities. The notice will also include instructions on how to submit related documents to the State to continue your coverage.  

Beginning January 1, 2027, some Medicaid members will need to renew their coverage every 6 months instead of once a year. This change comes from a new federal law and applies only to certain adults. 

The new rule affects people who are ages 19–64 and get Medicaid through the Medicaid expansion program (sometimes called “expansion adults”). 

The expansion program, or “expansion adults”, typically refers to adults between ages 19-64 who are not pregnant, are not a parent/caretaker of a minor child, and do not have Medicare.

If this new federal law will affect your Medicaid, the State will let you know before it goes into effect.  You will get a notice from the State of Rhode Island in your HealthyRhode account. If you’ve signed up to receive paper notices, you will also get a copy sent to you in the mail. 

The notice will have instructions on how to renew your Medicaid coverage. It will also have information about how to file an appeal if you disagree with any decision the State makes about your Medicaid coverage.  

Starting in 2027, the amount of time Medicaid can cover medical bills from before your application date will change. This is sometimes called “retroactive coverage”.

Federal rules currently allow Medicaid to pay for medical bills from up to three months before someone applies.

In Rhode Island today, coverage for past medical bills is only available to:

• People with disabilities
• Adults age 65 and older
• People applying for long term services and supports (LTSS), including through the Katie Beckett pathway
• Pregnant people
• Infants under age 1

What’s changing

A new federal requirement will change how far back Medicaid can cover medical bills. Starting in 2027, coverage can go back up to 2 months before enrollment.