New Medi-Cal requirements begin in 2027 – Welcome to San Bernardino County

"San Bernardino County Update", yellow arrowhead and "SBCounty.gov

A staff member wearing an apron and gloves serves food to community members while other volunteers assist at a food distribution site. — *Community engagement activities, such as volunteering, may help eligible Medi-Cal members meet new requirements beginning in 2027.*

San Bernardino County encourages Medi-Cal members to prepare for new federal requirements related to work, community engagement and coverage renewal that will take effect in 2027.

Under new federal law H.R. 1, some adults ages 19 through 64 who receive Medi-Cal through the Affordable Care Act (ACA) expansion — known as theNew Adult Group — will need to meet Work and Community Engagement Requirements (WCER). These members will also be required to have their Medi-Cal eligibility reviewed more often.

Not all Medi-Cal members will be affected. The California Department of Health Care Services (DHCS) is in the process of sending information to members who may be impacted.

When will the new rules begin?

Beginning Jan. 1, 2027, certain new applicants will be evaluated for WCER when they apply for Medi-Cal.

For current members, changes will begin in March 2027. Members will receive notices explaining the requirements that apply to them and whether additional information is needed.

What is the Work and Community Engagement Requirement?

Impacted members will be required to work at least 80 hours per month, or an equivalent alternative. Accepted options include:

Working, including paid, self-employed or in-kind work, for at least 80 hours a month
Volunteering or completing community service for at least 80 hours a month
Participating in a qualifying work or job-training program for at least 80 hours a month
Attending school at least half-time
Having a monthly income of at least $580 (80 hours at the federal minimum wage)
Combining any of the above activities to reach 80 hours a month

Additional options may apply to seasonal workers or people whose income or work hours fluctuate.

Some members can be excused from the new work requirements. Examples include:

People who are pregnant or receiving postpartum care
Parents or caretakers of children age 13 or younger
People with medical conditions or disabilities that prevent them from meeting requirements.
People with Medicare coverage
American Indian or Alaska Native status
Certain former foster youth younger than age 26

The county will work with Medi-Cal members to review available information and determine whether members must meet work requirements or qualify to be excused. If more information needs to be submitted, the county will provide further instructions explaining what to provide and when it is due.

What will change about Medi-Cal renewals?

Affected members will have their Medi-Cal eligibility reviewed every six months instead of once a year.

For example, a current New Adult Group member who completes their scheduled renewal in March 2027 will have another renewal review in September 2027.

Members in other coverage groups will continue to follow their existing renewal schedules. Being excused from the work requirement does not automatically mean a member is excused from six-month renewals.

The county may be able to help members renew their coverage using information already available. If a renewal form or additional information is requested, members must respond by the deadline provided.

Outreach already underway

DHCS began a text message campaign in February 2026 to notify members and began mailing outreach letters to current New Adult Group members in August 2026. Letters are available in multiple languages. San Bernardino County is also including this information with application materials it provides for both new and returning members through the end of the year.

Important: Not all Medi-Cal members will be affected by these changes, and many who are affected will qualify for an exemption. Additional details regarding verification requirements, forms and timelines will be shared as more information becomes available.

What should members do now?

To help avoid interruptions in coverage, Medi-Cal members are encouraged to:

Keep their mailing address, phone number and email address current with the county.
Check mail and online accounts regularly for Medi-Cal notices.
Return renewal forms and requested information by the stated deadlines.
Report changes in income or household circumstances as required.
Contact their county Medi-Cal office if they have questions or need help responding.

Members can use BenefitsCal online to manage their benefits, report changes, upload documents and review notices.

San Bernardino County will continue working with community partners, DHCS and the Centers for Medicare and Medicaid Services to share updates, resources and support as additional guidance becomes available. For the latest updates, visit the San Bernardino County Transitional Assistance and DHCS websites.

Additional County Update News – October 29, 2026