What to Know Now to Prepare for Federal Changes 
Coming in Late 2026/Early 2027

What's happening?


A new federal law passed in summer 2025, known as House Resolution 1 (HR1) or “the One Big Beautiful Bill Act.” This new law requires states to change their Medicaid programs.

Nothing is changing right away. Starting in late 2026/early 2027, some adults will have to meet new requirements to qualify for Medicaid. 

Who does this impact? 


These changes will primarily impact:

• Adults ages 19-64 who aren’t pregnant (those enrolled in Medicaid Expansion)
• Immigrant adults, age 19 and older, who aren’t pregnant

👩‍👦Children and pregnant individuals are NOT impacted by these changes in Virginia. 

What is changing?


➡️More frequent check-ins (renewals):

• Currently, Virginians must renew their Medicaid coverage once a year.
• Starting in 2027, adults enrolled in Medicaid Expansion will need to renew their coverage twice a year (every six months).
• Click here for more information.

➡️Work/community engagement requirements:

• Currently, there is no requirement to work or participate in other activities to qualify for Medicaid.
• Starting in 2027, adults applying for or enrolled in Medicaid Expansion will need to:
• Work or do other activities (such as volunteering or education/school) for at least 80 hours per month, OR
• Qualify for an exemption, such as having special medical needs
• Click here for for more information, including an FAQ (English/Spanish) on the activity requirements and exemptions.

➡️Changes to eligibility for certain immigrants:

• Currently, adults with various legal immigration statuses can qualify for Medicaid.
• Starting October 1, 2026, non-pregnant immigrant adults will qualify for Medicaid if they are:
• Lawful Permanent Residents (green card holders),
• Cuban and Haitian entrants, OR
• Compact of Free Association (COFA) migrants.
• Individuals who are no longer eligible due to their immigration status may be eligible for Medicaid payment of emergency services. Click here for more information on the new immigration status rules, also available in other languages.
  

👩‍👦Remember, the above changes do NOT apply to children (age 18 and under) and pregnant (or postpartum) individuals!

What should I tell my patients/clients to do now? 


Nothing new yet! Your clients/patients should continue to: 


💻Report any changes (especially if they move!), so the state has up-to-date information and can contact them later this year about these changes.


🩺Keep using their Cardinal Care coverage to go to the doctor and dentist!

What can I do to get ready and learn more? 


✅Review (and bookmark!) the resources linked above

✅Subscribe to updates from DMAS

✅Stay informed through your subscription to SignUpNow emails. Were you forwarded this email? Subscribe here.

✅Enroll in a SignUpNow workshop (see info below!)

Announcing Spring/Early Summer 2026 SignUpNow Workshops!

The Virginia Health Care Foundation’s (VHCF) SignUpNow training workshops cover the ins and outs of the Medicaid/FAMIS programs, with a focus on eligibility and enrollment processes. We are regularly updating these workshops to reflect the upcoming federal changes.

Do you work with adults, children, and/or pregnant individuals? Register for a SignUpNow – Medicaid/FAMIS workshop!


Do you work with seniors and/or people with disabilities, and have you completed the Medicaid/FAMIS workshop? Register for a SignUpNow – Aged Blind Disabled (ABD) workshop!

Do you want to learn about the full spectrum of Medicaid/FAMIS programs? Register for both workshops, and/or complete the trainings via our online modules when it’s convenient for you! Access live workshop registration and on-demand content here. 

Other Health Coverage Updates

New Health Coverage Option for Pregnant Individuals

There is now an extra-special Special Enrollment Period on Virginia’s Insurance Marketplace for pregnant individuals! Pregnancy is now considered a “qualifying life event.” Pregnant individuals just need to attest to their pregnancy on their Marketplace application and will then have 60 days to enroll in coverage. This is a great option for pregnant individuals who are uninsured and have incomes too high to qualify for FAMIS MOMS.


If you ever are working with someone whose income is too high to qualify for Medicaid/FAMIS, be sure to refer them to an Enroll VA navigator to review their options. And don’t forget: Virginians can apply for/enroll in Medicaid/FAMIS 365 days a year! They are not required to enroll within a specific time window.

Update! Change in Cover Virginia Call Center Hours - Closed Saturdays


Effective April 4, 2026, the Cover Virginia Call Center is closed on Saturdays. The Call Center will continue to operate Monday through Friday, from 8 a.m. to 7 p.m., except on state-recognized holidays. Call Cover Virginia at 1-855-242-8282 for assistance with Medicaid/FAMIS applications, renewals, and coverage questions. 

Virginia Health Care Foundation Resources

General Assembly 2026 Updates


Virginia’s General Assembly wrapped up this year on March 14^th, having sent over 1,200 bills to Governor Spanberger’s desk. However, one key bill – the two-year state budget bill – was not passed. So, what’s next? 


The General Assembly is reconvening to finalize this year’s laws and budget:

• On April 22^nd, the GA reconvenes to review bill amendments and vetoes from the Governor.
• On April 23^rd, a special session will begin to finalize the state budget.


VHCF is tracking various policy and budget items impacting the health safety net and Medicaid – stay tuned for more updates after the General Assembly wraps up!

VHCF in the News! Expanding Access to Maternal Mental Health 


VHCF was recently featured in a Cardinal News article, highlighting programs in Virginia expanding access to women’s health care. VHCF’s statewide special initiative It Takes a Village bridges critical gaps in maternal mental health care with accessible, inclusive counseling statewide. Services are available at low or no cost and without a referral—powered by strong community partnerships and state support. For more information and a full list of participating locations click here. 

Resource from Cardinal Care Smiles/DentaQuest for Your Patients/Clients: Building a Relationship with Your Dental Home

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