Ohio adults ages 19 to 64 on Medicaid expansion coverage must show 80 hours a month of work, school, volunteering or job training, or monthly income of at least $580, starting Jan. 1, 2027. The Ohio Department of Medicaid says renewals for the same members also move from every 12 months to every six months on that date. Members who cannot show the hours or an exemption can be denied or dropped.
The rule covers what the state calls Group VIII, also labeled MAGI Adult or Ribicoff coverage, which is for adults with income at or below 138% of the federal poverty level, according to the Ohio Department of Medicaid’s work requirement page. Anyone in that group has two jobs before January: find out whether an exemption applies, and if none does, start saving proof of hours or pay.
Congress required the change in the 2025 budget law, and states must have it running for expansion adults by Jan. 1, 2027, the Health Policy Institute of Ohio says. Ohio’s start date matches the federal deadline, and the state’s materials do not list a delay.
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What counts toward the 80 hours
The state’s member notice lists four kinds of qualifying activity. Paid or unpaid work counts, including caregiving, work in exchange for goods or housing, and internships. Community service through a nonpolitical group, a government agency or a religious organization counts as well.
Recognized work programs such as Ohio Means Jobs also count, and so does school at least half-time, whether high school, GED, college or technical training. Hours from two or more activities can be added together. Seasonal workers may use their average monthly income instead.
The dollar test is simple. The state says $580 a month equals the federal minimum wage times 80 hours, so a member earning at least that much meets the requirement without logging hours. Proof is pay stubs or an employer statement for work, a letter from the organization for community service or a work program, and proof of enrollment or a class schedule for school, according to the state’s outreach notice language.
Who is exempt from the rule
The state lists a long set of exemptions. Pregnant members and those in the 12 months after a pregnancy are exempt. So are parents, guardians, caretaker relatives and family caregivers of a child 13 or younger or of a person with a disability.
Veterans with a 100% service-connected disability rating are exempt, along with current or former foster youth under 26 and Native American members. People in drug or alcohol treatment, people who are incarcerated or were recently released, and people who already meet SNAP or Ohio Works First work rules are exempt too.
Medically frail members are exempt as well. The state’s description includes people who are blind or disabled under Social Security’s definition, people with a substance use disorder, people with a disabling mental disorder, people with a significant physical, intellectual or developmental disability, and people with a serious or complex medical condition. Adults under 19 or 65 and older, anyone entitled to Medicare Part A or enrolled in Part B, and anyone eligible under another Medicaid category are exempt for any month that applies.
What happens at the six-month renewal
New applicants have to show they met the requirement in the month before applying. At renewal, a member must show compliance for at least one month since the last application or renewal, according to the state’s August 2026 partner packet. With renewals every six months, that proof comes due twice a year.
The state says it will first try to confirm eligibility electronically and will send a request for more information if it cannot. A 30-day noncompliance period starts when a verification checklist is sent. If a member lacks qualifying activity or an exemption, the application is denied or benefits are discontinued, and a notice explains the decision and how to ask for a state hearing. Members can reapply at any time.
The state’s outreach notice adds one more cost: losing Medicaid for this reason also ends eligibility for the premium tax credit on Marketplace coverage. Changes in income, address, household members or pregnancy must be reported within 10 days, online at benefits.ohio.gov, at a county Job and Family Services office, or by phone at (800) 324-8680. Callers can also dial 211 for help finding local resources.
How many Ohioans could lose coverage
The Health Policy Institute of Ohio, a nonprofit research group, said in a July 31 update that the consulting firm Manatt projects Ohio’s Medicaid enrollment will fall by 305,000, or 10%, by 2028 because of the work requirements. The group said the federal interim rule released in June adds an estimated 64,000 more people losing coverage. Those are projections, not counts of anyone dropped so far.
The state’s pages do not give a member count for the expansion group and do not say when the mandatory outreach notices will be mailed. Members whose contact information is out of date risk missing the first letter, so the county office or the benefits portal is the place to confirm an address.
Can an Ohio Medicaid member prove 80 hours by the first six-month renewal?
Under Ohio’s new rule, a Medicaid expansion member who cannot show hours or an exemption can be denied or dropped, and renewals now come twice a year instead of once. The related job for any household on SNAP or Medicaid is keeping every renewal date, report and piece of proof in one place.
The SNAP & Medicaid Renewal Organizer includes 51 state packs and a renewal and reporting calendar, plus a section on the new Medicaid work requirement and who is exempt. It runs 20 pages.
Get the Ohio Medicaid renewal and reporting calendar in the SNAP & Medicaid Renewal Organizer →
This article was produced with AI assistance and edited for accuracy against the sources linked above.
