A new federal law is bringing major changes to Medicaid, and those changes will affect how many Vermonters apply for and keep their health coverage. Most of the changes begin in 2027, but some start as soon as October 1, 2026. At Little Rivers Health Care, we want every patient to stay informed and stay covered.

Our Care Coordinators can help you apply for or renew health insurance, find prescription assistance, apply for our Sliding Fee Scale, and connect with other resources in our community. They can also meet with patients through home visits. If you have questions about how the new Medicaid rules affect you or your family, our team is here to walk you through it. Learn more about Care Coordination at LRHC.

The Department of Vermont Health Access (DVHA), which runs Vermont Medicaid, has shared details about what is changing. Here is a summary of what you need to know.

Changes for Certain Immigrants (Starting October 1, 2026)

The new law limits which non-citizens can receive Medicaid. Going forward, eligibility will be limited to certain lawful permanent residents, Cuban/Haitian entrants, and Compact of Free Association (COFA) migrants.

These changes do not apply to non-citizens who are pregnant or under age 21.

DVHA has sent notices to immigrants who may be affected, available in English, Arabic, Dari, French, Nepali, and Spanish. Informational videos are also available in several languages, including Mandarin, Pashto, Somali, and Swahili.

Changes for Some Adults Ages 19 to 64 (Starting January 1, 2027)

If you are between 19 and 64 and have Medicaid, three new rules may affect you.

1. Work requirements, also called "community engagement"

You will need to show that you spend time working, volunteering, or going to school. You can meet this requirement in one of two ways:

• Earning at least $580 per month (while staying under the Medicaid income limit, which is about $22,025 per year for one person or $45,540 for a family of four), or
• Spending at least 80 hours per month on any combination of work, self-employment, community service, education, or work programs.

New applicants will need to show they met the requirement in the month before they apply, beginning January 1, 2027. Current members will need to show it when they renew, beginning March 1, 2027.

Some people are excused from work requirements. Examples include caring for a child under age 14 or a person with a disability, or having certain health conditions.

2. Renewals every six months

Instead of renewing your Medicaid once a year, you will need to renew every six months. Keeping your contact information up to date with Vermont Medicaid will help make sure you don't miss important notices.

3. Less retroactive coverage

Retroactive coverage helps pay for medical care you received before you applied. This period will shrink to one month for most affected adults, and to two months for people who are pregnant and children under 19.

Who Is Not Affected by the 2027 Changes?

You do not need to worry about these new rules if you are:

• Under age 19
• Age 65 or older
• Pregnant, or up to 12 months after giving birth
• Entitled to or enrolled in Medicare

Not Sure If This Applies to You?

DVHA has a short online screening tool that asks a few questions to help you find out whether you may need to meet work requirements. https://dvha.vermont.gov/medicaid-work-requirements-screening-tool

DVHA has begun mailing information to affected members this summer. Please open and read any mail you receive from Vermont Medicaid or Green Mountain Care.

Reach Out Anytime

You don't have to figure this out alone. Whether you need help renewing, keeping track of work hours, or checking if you qualify for an exclusion, our Care Coordinators can help. Call us at [phone number] or ask at your next visit in Bradford, East Corinth, Newbury, or Wells River. For the latest updates directly from DVHA, visit Federal Medicaid Changes: Vermont Impact | Department of Vermont Health Access .

Taking care of your health starts with staying covered, and we're glad to help you take that first step.