Medicaid work rule · Pennsylvania · checked 2026-10-20
Medicaid work requirement in Pennsylvania: what applies to you in 2027
Starting no later than January 2027, most adults 19 to 64 on Medicaid expansion must show 80 hours a month of work, school, volunteering or a work program, or $580 of income, unless the rule does not apply to them. Below is what Pennsylvania has published about how it will check, with a link to each source. Pennsylvania decides; this page only explains.
What Pennsylvania has published
- When it starts
- 2027-01-01 for applicants. Current recipients are checked starting at their next renewal in 2027; 'Medicaid coverage will not automatically change on January 1.' Outreach began Aug-Sep 2026. No separate soft-launch or no-disenrollment period is published.Sources: 1 2 (Pennsylvania's own pages, listed below) · checked 2026-10-20
- Whether your own word counts in 2027
- Yes for most activities and exemptions in 2027, but paid work must always be verified (for example a pay stub). Self-attestation ends in 2028. No state-law bar was found in agency sources.Sources: 1 2 (Pennsylvania's own pages, listed below) · checked 2026-10-20
- How many months it looks back
- Application: the 1 month before the month of application. Renewal: at least 1 month since the last renewal.Sources: 1 2 (Pennsylvania's own pages, listed below) · checked 2026-10-20
- How often you renew
- 6 months. Current recipients switch after completing their next renewal in or after Feb 2027. New 2027 applicants renew 6 months after benefits start.Sources: 1 2 (Pennsylvania's own pages, listed below) · checked 2026-10-20
- How it checks medical frailty
- DRAFT strategy, not approved by CMS (May 2026 deck). DHS will review claims against a list of eligible conditions. That list is preliminary, built from the CMS Chronic Condition Warehouse and other sources and refined by clinical review. DHS will also use the P3N health information exchange (admission/discharge notices, aimed at new applicants), MCO health risk assessments and case-management data, and information the applicant provides when records miss a condition. Deck: www.pa.gov . No public condition list and no CMS-tier mapping are published.Sources: 1 2 (Pennsylvania's own pages, listed below) · checked 2026-10-20
In Pennsylvania's own words
“Paid work must always be verified, so you need to provide information to PA DHS showing that you received payment, such as a pay stub.”pa.gov
“In 2027, most other work activities and exemptions can be verified by answering questions (self-attestation) on your application or renewal.”pa.gov
“For a renewal, if you do not meet an exemption, you will need to provide information to show that you are meeting the work requirement in at least one month since your last renewal.”pa.gov
Not published yet
Pennsylvania has not said this yet on the pages checked. Ask your Medicaid office, and keep copies of what you send.
- Final (CMS-approved) frailty method and condition list
- Whether PA adopts the CMS Sept 2026 3-tier model
- Which specific exemptions, if any, are excluded from 2027 self-attestation besides paid work
Sources
Pennsylvania's own Medicaid pages, read on 2026-10-20. The federal rule behind every state is in rules.json, with its own sources.