FAQ: New Work or Activity Rules

Know Your RightsOregon Health Plan (Medicaid) Changes
Written By Melissa Roy-Hart

Oregon Health Plan (Medicaid)

 

Start Here

  • The Oregon Health Plan (OHP) is changing. Some changes start January 1, 2027.

  • You do not lose your health care right now.

  • There are new rules: some adults will need to show they work, volunteer, go to school, or earn money.

  • OHA is sending a letter to about 600,000 households about the new rules.

  • Many people do not need to follow the new rules.

  • Check your mail every day. Missing paperwork is the biggest risk.

  • Read on for answers to many questions.

  • Need help? Call OHA at 800-699-9075. Or go to the section called "Get Help" at the bottom of this page.

 

About the Letter From OHA

OHA is mailing a letter about new work rules to people on the Oregon Health Plan (Medicaid). The letter is going to the whole household. It may be about someone else in your household.

What will OHA do?
At your renewal, OHA will check if you are exempt. OHA will use information it already has. If OHA needs more, it will send you another letter.

Do I have to answer the letter?
No. But you can tell OHA about your exemptions or activities now. This can make your next renewal easier.

Make sure OHA has your contact information:

  • mailing address

  • phone number

  • email

 

The Basics

Is the Oregon Health Plan the same as Medicaid?
Yes. The Oregon Health Plan (OHP) is Oregon's Medicaid program. Many Oregonians with disabilities use OHP to get:

  • home care

  • healthcare

  • support to live in the community

Why is the Oregon Health Plan (OHP) changing?
A new federal law says OHP must change. (A federal law is a law for the whole country. This law is called H.R. 1.) The changes will happen from late 2026 through 2028.


There are two big changes:

  1. Some adults will have new work or activity rules.

  2. Some people will have to renew OHP more often.

 

Will I lose my health care?
Most people will keep OHP. Some people could lose it if they miss a step. The biggest risk is missing paperwork. Check your mail every day.

 

Do the New Work or Activity Rules Apply to Me?

The new rules start January 1, 2027. The rules are for some adults. They are not for everyone.

 

Does having a disability mean my healthcare is safe?
No. A disability alone does not protect you. There are two ways to be outside the new rules:

  • Way 1: You are in a special group.

  • Way 2: You get an exemption.

Watch this video from OHA about the new rules:

 

Special Groups: the rules do NOT apply to you if you:

  • are pregnant

  • have Medicare

  • get Supplemental Security Income (SSI) 

  • are under 19 years old

  • are over 65 years old

OHA also says some disability programs are exempt from the rules. OHA has not said which programs.

 

You should contact OHA now to find out if your disability program qualifies for an exemption:

 

Exemptions: you do NOT have to follow the rules if you:

Health and disability

  • are blind

  • have a serious or disabling health condition (see the next section)

  • have an alcohol or drug use disorder, or are in treatment

  • have Medicare Part A, or are enrolled in Medicare Part B

Family

  • care for a child under 14

  • are pregnant, or were pregnant in the last 12 months

  • care for someone with a serious health condition (see "What if I care for someone with a serious health condition?" below)

  • spent at least 1 week away from home to get health care for yourself or a child

  • missed time at work or school to help a child who traveled for health care

Age and background

  • recently turned 19

  • are American Indian or Alaska Native

  • left foster care at age 18 and are now 19 to 26

Life events

  • are in jail or prison

  • just got out of jail or prison

  • stayed overnight in a hospital or care center

  • got critical care or services at home or in another place

  • lived in a disaster area, or a county with high unemployment (OHA will tell you if this applies)

Other programs

  • get SNAP (food benefits) and meet the SNAP work rules

  • get TANF (cash help for families) and meet the TANF work rules

  • were in certain other OHP programs before your renewal

 

Read your letter from OHA. See where you fit.

For examples and a checklist, see OHA's fact sheet: Exemptions for OHP Work or Activity Rules.

Not sure? Contact OHA:

 

Were you denied an exemption? Are you at risk of losing OHP?

Tell Disability Rights Oregon. We work to protect the Oregon Health Plan services our community needs. This work will continue throughout the 2027 legislative session and beyond.

Want to join us? Sign up for OHP/Medicaid updates >

 

Serious or Disabling Health Condition Exemption

What is this exemption?

This exemption is for people who are blind. It is also for people with a serious or disabling health condition. OHA says it is for people whose health problems make it hard to work at least part-time.

 

Is it automatic if I have a disability?

No. The exemption looks at how your health affects your daily life and work. It is not just about the name of your condition. Having a diagnosis is not enough by itself.

 

What health problems and disabilities might count?

OHA gives these examples:

  • cancer treatment

  • kidney dialysis

  • major depression

  • substance use disorder

  • diabetes with health problems

  • blindness

  • Down syndrome

  • cerebral palsy

  • other big physical, learning, or developmental disabilities

Other health problems and disabilities may count, too. Ask OHA if your condition counts.

 

Do I have to prove it?

In 2027:

  • You can tell the state you have an exemption.

  • You do not need a doctor's note.

In 2028:

  • You may be asked for proof, like a note from a doctor.

  • Start saving your papers now.

 

What papers can help?

  • doctor and clinic visit records

  • a letter from your doctor, nurse, or case worker that says how your health limits your work or daily life

  • hospital or care center papers

  • records of care you get, like therapy or home care

  • your SSDI, SSI, or VA letters

 

What else can I do?

  • See your regular doctor at least 1 time a year.

  • Go to your follow-up visits.

Regular care may help OHP see that you qualify.

 

What if I care for someone with a serious health condition?
You may be exempt if you care for someone with a serious or disabling health condition.

You must give at least 80 hours of care each month. (That is about 20 hours a week.)

  • The person does not have to be family.

  • The person does not have to live with you.

In 2028, OHP may ask you to show a calendar of your hours.

 

If the Rules Apply to Me, What Do I Do?

You only need to do 1 of 3 things:

  1. Money: Your home earns at least $580 a month before taxes.

  2. School: You go to school half-time or more. High school and GED programs count.

  3. Hours: You do at least 80 hours a month (about 20 hours a week) of any of these:

    • work

    • volunteering

    • caring for someone

    • school

    • a work training program

Unpaid work, seasonal work, and self-employment count.

Some activities may not count or may have limits.

Learn more: OHP.Oregon.gov/HR1.

 

What if I can only work a few hours?
Some people with disabilities can work, go to a training program, or use job supports. But they cannot do 80 hours.

Ask OHA:

  • Do my hours count?

  • What can I do if I cannot reach 80 hours?

 

Proof

When does OHP check the rules?
When you sign up or renew. OHA will first look at information it already has. If it needs more, it will send you a letter. Check your mail every day.

 

What can I use as proof?

  • Money: pay stubs or bank papers

  • School: a class schedule or a letter from your school

  • Hours: timesheets, a calendar of your hours, or a letter from your job or volunteer place

 

What if I do not follow the rules?
Your OHP could end.

You might be able to buy insurance at OregonHealthCare.gov. But you might not get help paying for it.

 

Other Changes

 

How often will I renew OHP?
This starts in late 2027. The date depends on your household’s renewal date.

Every 6 months (instead of every 2 years) if you are:

  • an adult 19-64 years old, and

  • not on Medicare, and

  • not in a disability program or pregnancy program, and

  • not American Indian/Alaska Native. Everyone else, including children, will renew once a year. This begins in late 2027, depending on when your household's renewal falls.

Every year for everyone else, including children.

Children under 6: Before, they could keep OHP until their 6th birthday without renewing. That rule is ending.

 

What is changing about financial help with old medical bills?
This starts January 1, 2027. New members and people who reapply after losing coverage will get less financial help to pay for old medical bills.

Now: OHP can help pay for old bills from up to 3 months back.

After January 1, 2027, you will have:

  • 1 month for most adults 19-64 years old

  • Up to 2 months for

    • children

    • people over 65

    • people who are pregnant

    • people on disability-based OHP programs

 

Get Help

Need Help? Contact OHA:

 

Were you denied an exemption? Are you at risk of losing OHP?

Tell Disability Rights Oregon. We work to protect the Oregon Health Plan services our community needs. This work will continue throughout the 2027 legislative session and beyond.

Want to join us? Sign up for OHP/Medicaid updates >

 
Go to Oregon Health Plan (Medicaid) Know Your Rights
 

Copyright © 2026 Disability Rights Oregon

900 SW 5th Ave, Suite 1800, Portland OR 97204
E-mail: welcome@droregon.org
Website: droregon.org

Disability Rights Oregon is tax-exempt under Section 501(c)(3) of the Internal Revenue Code. Contributions are tax-deductible and will be used to promote the rights of Oregonians with disabilities. 

Portions of this document may be reproduced without permission, provided that Disability Rights Oregon is appropriately credited. 

NOTICE: This document is not intended as a substitute for legal advice. Federal and state law can change at any time. You may wish to contact Disability Rights Oregon or consult with an attorney in your community if you require further information.

Melissa Roy-Hart
Next

Reporting Crime to Police