The Medicaid Work Requirement and BeWell

You may have heard that Medicaid enrollees will soon have to satisfy a community engagement requirement, also called a work requirement, to keep their coverage. Starting in 2027, many adults ages 19 to 64 who are enrolled in Medicaid will need to complete 80 hours of work or activity requirements (like working, volunteering, or going to school at least half-time) in a month and report those activities at their renewal, unless they qualify for an exemption. (Visit the Health Care Authority’s website for more information.)

What happens if someone doesn’t satisfy the work requirement and loses Medicaid as a result? Can they enroll in coverage through BeWell?

Yes, but they won’t qualify for federal financial assistance, like advance premium tax credits (APTC) or cost-sharing reductions (CSR). They also will not qualify for state financial assistance like New Mexico Premium Assistance (NMPA).

This is because federal law considers someone in this situation to still be eligible for Medicaid – even if they haven’t met the key work requirement – which makes them ineligible for federal financial assistance through state-based marketplaces like BeWell (see 42 U.S.C. § 1396a(xx)(7)(B)). This means these individuals will also be ineligible for state financial assistance.

These individuals can still enroll in coverage through BeWell, but they will be required to pay the full price for their plan – which means their best option is to hold onto their Medicaid coverage.

For more information on how to keep your Medicaid coverage, visit the HCA’s website.

Does the work requirement apply for people with coverage through BeWell?

There is no work requirement to enroll in or keep coverage through BeWell. However, if you’re enrolled in coverage through BeWell and anticipate needing Medicaid coverage later, be sure to stay informed about these requirements by checking HCA’s website.