The Wisconsin Department of Health Services is preparing to implement new federal Medicaid work requirements that could put health insurance coverage at risk for tens of thousands of BadgerCare Plus members.
Department of Health Services Secretary Kirsten Johnson and Wisconsin Medicaid Director Amanda Dreyer answered questions from reporters Thursday about how the state plans to roll out the new requirements and what members should do now.
Here’s what you need to know.
Who is impacted
The new requirements were created under the One Big Beautiful Bill Act. The law requires states to implement Medicaid work requirements for some adults.
In Wisconsin, the requirements apply to BadgerCare Plus members ages 19 to 64 who do not have a dependent child under the age of 19 living with them.
About 200,000 Wisconsin adults will be subject to the new requirements. The agency estimates that approximately 63,000 people are at immediate risk of losing their health care coverage because the state does not currently have documentation showing they meet the requirements or qualify for an exemption.
New requirements
To keep Medicaid coverage, affected members must show they have completed at least 80 hours of employment, volunteer work, school or job training or another qualifying activity in one month over a 12-month-period since they were last approved for healthcare coverage.
Some people may qualify for exemptions, including those who are medically frail or family caregivers, but Department of Health Services leaders say they are waiting for additional federal guidance on what documentation will be required.
Work requirements will take effect for new Medicaid applicants early next year. Starting January 2027, new applicants will need to meet the federal work requirement in the month before they submit an application.
Current BadgerCare Plus members will be subject to the requirements during their renewals starting in March 2027.
What you can do
State officials say the most important step is making sure the department has current contact information.
Medicaid members should keep their mailing address, phone number and email address up to date to ensure they receive important notices about the upcoming changes. Members can update their information through the ACCESS Wisconsin website or the ACCESS smartphone app.
The department also recommends keeping documentation such as pay stubs, volunteer records or school enrollment information that may be needed during the renewal process.
Where possible, the Department of Health Services plans to use existing medical records and diagnosis codes to identify people who qualify for exemptions rather than requiring new paperwork. During the program’s first year, members who believe they are medically frail will be allowed to self-attest while supporting documentation is obtained.
Resident outreach
Department of Health Services is working with health care providers, counties and community organizations to prepare for the changes, with a particular focus on helping people experiencing homelessness and others who may have difficulty meeting the new reporting requirements.
The department has also created a “Medicaid: New Federal Work Requirement” webpage that they will update with new information about eligibility, exemptions, reporting requirements and implementation timelines.
Johnson said the state’s goal is to ensure everyone who qualifies for Medicaid can keep their coverage despite the new federal requirements.
Department of Health Services leaders estimate the first year of implementation will cost about $10 million in system upgrades, with additional staffing and training costs still being finalized. Officials say they will continue working with local partners to help members understand the new rules and avoid unnecessary loss of health coverage.
Jonathan Aguilar is a visual journalist at Milwaukee Neighborhood News Service who is supported through a partnership between CatchLight Local and Report for America.
