The federal government has issued a rule requiring that, beginning January 1, 2027, certain adults ages 19-64 who are applying for or currently enrolled in Medicaid through the Healthy Michigan Plan (HMP) must work or participate in other approved activities to maintain their health coverage.
Many people that need to meet this requirement may already be doing so through work, school or other approved activities and some others may qualify for an exemption.
Rural healthcare and community organizations may encounter patients who:
MCRH has gathered information and resources to help rural healthcare organizations, providers and community partners understand these changes and support Healthy Michigan Plan members.
Review current work requirement information
Join MDHHS on Tuesday, October 20, from 3–4 p.m. ET to learn how to help individuals navigate the new work requirement process. The session will review details of the medical frailty exemption and introduce a new screening tool designed for community partners to help beneficiaries understand whether they are exempt, already meeting, or may need to meet work requirements.
Registration is limited to two participants per organization. The webinar will be recorded and shared by October 28. For questions about registration or to report issues registering, contact ProviderOutreach@Michigan.gov.
Guidance may change. Visit the MDHHS Healthy Michigan Plan website for current eligibility, exemption and reporting information. Organizations should use current MDHHS materials when communicating eligibility or reporting information to patients.
The MDHHS Community Partner Toolkit contains materials to help healthcare organizations and community partners educate and assist Healthy Michigan Plan members as the work requirements are implemented.
Many of these materials direct members to the Healthy Michigan Plan website, where they can find the most current information. MDHHS will continue adding resources to support implementation.
The HR1 & Medicaid Webinar Series helps healthcare organizations and community partners understand and communicate changes to Medicaid resulting from HR1. The series primarily focuses on Healthy Michigan Plan work requirements and how organizations can help Michigan residents prepare for these changes.
Learn about the basics of the provisions and changes from the Centers for Medicare & Medicaid Services, how MDHHS is planning and preparing, and available communication tools and resources.
Learn how MDHHS will turn policy into practice, including who is impacted by work requirements, available exemptions and exclusions, way participants can meet the requirements, verification processes, and other key implementation details.
Visit the MDHHS Community Partner Toolkit webpage to find the latest webinar recordings and resources and sign up for the HMP Work Requirements Listserv.
Some Healthy Michigan Plan members may be excused from meeting the work requirements. This is called an exemption.
Exemptions may apply to people who are:
Exemptions may also apply to individuals experiencing temporary hardship, which is a short-term situation that may make it hard to work or complete other qualifying work activities. In these cases, people may not need to meet work requirements for a limited period of time. Temporary hardships include:
The Center for Health & Research Transformation (CHRT)’s August 2026 brief, HR1 and Michigan Medicaid: Work Requirements, provides an overview of the changes.
The Michigan Nonprofit Association (MNA) launched a statewide Medicaid Community Support Network and is sharing updates, resources, training opportunities, and information to ensure that nonprofit organizations have the tools they need to support their communities through this transition. Visit MNA’s https://readyformedicaidchanges.org/ site for more information and visit the resources page to browse available resources.
These include a guide to Changes to Medicaid for Some Non-Citizens starting October 1, 2026, available in English, Spanish, and Arabic.
Last updated: September 22, 2026
MCRH provides these resources to support rural healthcare organizations and community partners. MDHHS remains the authoritative source for Healthy Michigan Plan eligibility, coverage and implementation guidance.
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