When Do Pennsylvania Medicaid Work Requirements and Six-Month Renewals Start?

Updated November 4, 2026, based on the Pennsylvania Department of Human Services (DHS) and CMS as of that date.

Pennsylvania's Medicaid work requirements start January 1, 2027, for expansion adults ages 19 to 64. Six-month renewals start the same year, but people already enrolled switch only at their next renewal. In its H.R. 1 Community Briefing slides from August 26, 2026, the Department of Human Services (DHS) says recipients with renewals due from September 2026 through January 2027 renew under the old rules and won't renew again for a year. Renewals due in February 2027 or later follow the new rules.

DHS puts the affected group at about 800,000 Pennsylvanians in the Medicaid expansion group. Pennsylvania also calls the program Medical Assistance (MA). Retroactive coverage for new applicants shrinks on the same date. For the federal rules behind all of this, see our guide to the federal changes.

When each change starts in Pennsylvania

• October 1, 2026: some noncitizens, including refugees, asylees and humanitarian parolees, lose Medicaid eligibility, according to the DHS Medicaid Changes FAQs.
• January 1, 2027: work requirements begin for adults 19 to 64 without a dependent child under 14, and retroactive coverage windows shrink.
• February 2027 onward: current expansion recipients renew under H.R. 1 rules, then every six months.

People who apply on or after January 1, 2027, renew six months after their benefits start. The DHS Changes Coming to Medicaid page gives an example: a current recipient whose renewal is due in March 2027 renews again in September 2027.

How Pennsylvania will renew expansion adults

DHS keeps each person's existing renewal date and starts the six-month cycle after it. That matches option 2 in CMS's slides on Section 71107 six-month renewals, which avoids a January 2027 pile-up of renewals. DHS doesn't name the option itself.

DHS hasn't described its ex parte (automatic) renewal process for the six-month cycle. Under the same CMS guidance, states must still try to renew from available data first, then send a prepopulated form with at least 30 days to return it. For work requirements, the briefing says DHS "will try to use information already available, including trusted data sources." If it needs more, the DHS page says it sends a letter and the person has 30 days to respond.

Members see their renewal date in COMPASS or the myCOMPASS PA app. From 2027, renewal forms ask about work requirements and exemptions.

How Pennsylvania will check work requirements

A member meets the requirement with at least 80 hours a month of work, school at least half time, volunteering or community service, or a job training program, in any combination. Household income of at least $580 a month also counts.

An applicant shows they met the requirement in the month before the month they apply, so a March applicant shows February. At renewal, a member shows at least one qualifying month since their last renewal.

Paid work must always be verified, for example with a pay stub. In 2027, if DHS can't confirm something electronically, members can self-attest to other activities and exemptions on the application or renewal. Income isn't covered by self-attestation. In 2028, members must provide proof.

DHS exempts people who are:

• Parents or caretakers of a child under 14 or of an individual with a disability
• Pregnant or postpartum
• American Indian or Alaska Native tribal members
• Veterans with a VA-determined total disability
• In alcohol or substance use disorder treatment
• In prison or jail in the last 4 months
• Former foster youth under 26
• Meeting TANF work requirements, or on SNAP and subject to SNAP work requirements
• Medically frail or with special medical needs

Temporary hardship also counts, such as a recent hospital, nursing facility or residential care stay, or travel for medical treatment.

Members report on the application or renewal form. They can upload documents through COMPASS or the myCOMPASS PA app, call the Customer Service Center at 877-395-8930 (215-560-7226 in Philadelphia), or mail or bring documents to their County Assistance Office. Losing a job between renewals doesn't end coverage for someone otherwise eligible.

What changes for providers and health centers

For new applicants, retroactive coverage drops from three months to one month for expansion adults and two months for everyone else. For an expansion adult who applies in March 2027, retroactive coverage reaches back only to February.

DHS plans to identify medical frailty "data first," and the DHS press release from September 10, 2026 says it will use "available data like recent medical claims" to help find exemptions. DHS hasn't said which claim fields or diagnosis codes it will use.

DHS asks partners to:

1. Become a COMPASS Community Partner, which lets your staff submit and track Medicaid applications.
2. List volunteer opportunities on PA Navigate (providers sign up at www.panavigatehelp.org).
3. Share the DHS Medicaid Changes Communications Toolkit, which has flyers, newsletter text, social posts, the text and call scripts, and the first outreach letter (CM 710).
4. Remind patients to update their address with both DHS and USPS and sign up for texts and e-notices.

The H.R. 1 FAQ line is 1-877-883-6383. The DHS materials don't describe a clinician attestation process.

What Pennsylvania hasn't decided yet

• Medical frailty: the DHS Federal Cuts page says the frailty approach "has NOT been approved by CMS" and may change. The briefing says DHS is still working with CMS on it after the June 1 interim final rule "unexpectedly changed requirements."
• Data sources: DHS says it is "committed to onboarding additional data sources" but doesn't list them.
• January 2027 renewals: DHS documents disagree. The briefing slides, the Changes Coming to Medicaid page and the press release put the switch at renewals in or after February 2027. The FAQs say members switch "after completing your first renewal that occurs in 2027," and the toolkit's call script says reporting starts "with your first Medicaid renewal in 2027." A January 2027 renewal falls on different sides of that line. Confirm with DHS before telling a January patient what to expect.
• School hours: the briefing and press release say school "at least half time." One list on the Changes Coming to Medicaid page says "at least part-time."

Frequently asked questions

Does anyone lose Pennsylvania Medicaid on January 1, 2027?

Not automatically. The DHS page says coverage "will not automatically change on January 1." Current recipients report at their next renewal, and DHS sends a notice before benefits change.

Can a patient self-attest to volunteering or school in 2027?

Yes, when DHS can't verify it electronically. That covers activities and exemptions other than income. Paid work always needs proof, and from 2028 the other items do too.

What if a patient's Medicaid closes for not reporting?

They can reapply at any time. They'll need to show they met the requirement or an exemption in the month before the month they apply.

Tracking six-month renewals across patients and portals?

Champ automates portal work like eligibility checks. We set it up and run it, so your staff sees only the finished results, and we can handle the patient outreach too. If six-month renewals will mean more coverage checks for your health center, learn more here.

This post is general information, not legal, compliance or billing advice. Medicaid rules vary by state and change often, so confirm with DHS before acting. Champ is not affiliated with or endorsed by any state agency or CMS.