Final federal rules released June 1, 2026 clarify how ~18.5M state-federal health coverage enrollees may document work, training, volunteering, or education to qualify.
The requirements apply to expansion adults, while children, pregnant people, disability beneficiaries, and medically frail enrollees are not subject to them under federal rules.
States are urged to use automated checks and existing records first; in 2027, enrollees may self-attest qualifying hours or medical limits when needed.
Qualifying paths include 80 hours a mo of work, community organization volunteering, community service documentation, unpaid internships, or college enrollment meeting half-time standards.
Most states roll out January 1, 2027, so enrollees should update contact details, watch mail or email, and contact local offices early.
