Medicaid is essential to the independence of hundreds of thousands of people with disabilities in Illinois. It pays for doctors, hospitals, prescriptions, behavioral healthcare, and services that enable many people with disabilities to live and work in their communities.
New federal Medicaid rules will begin changing eligibility and renewal requirements for some Illinois Medicaid recipients in late 2026 and 2027. These changes will not affect everyone in the same way. Many people with disabilities will not be subject to the new work requirements, and others may qualify for an exemption.
Having a disability does not mean that the Medicaid system will automatically recognize that you are exempt. Understanding what type of Medicaid coverage you have, keeping your information current, reading notices from the State, and responding when the State requests information will become increasingly important.
Access Living opposes any policies that create unnecessary barriers between people with disabilities and the healthcare and community-based services they need. Our goal is to help people understand these changes and protect their coverage.
Jump to Section:
- What is Changing
- Disability and New Work Requirements
- Who May Qualify for an Exemption
- How Do I Know What Type of Medicaid I Have?
- Protect Yourself from Losing Medicaid
- What Happens if Illinois Says I’m Losing Medicaid?
- Why Are These Changes Concerning for People with Disabilities?
- Important Dates
- What Should I Do Right Now?
What is Changing?
October 1, 2026: Changes for Some Noncitizens
Federal Medicaid eligibility will become more restrictive for some categories of noncitizens beginning October 1, 2026. If you receive Medicaid and believe your immigration status could be affected, do not assume that your coverage has ended. Wait for official notice from the State and seek assistance if you have questions about your eligibility.
January 1, 2027: New Requirements for Some ACA Adult Medicaid Recipients
Beginning January 1, 2027, some adults enrolled through the Affordable Care Act Medicaid expansion will have additional requirements to receive or maintain Medicaid.
Generally, the affected population includes adults who:
- are between ages 19 and 64;
- are not receiving Medicare; and
- are enrolled in the ACA Adult Medicaid eligibility group.
People who are subject to the requirement generally must demonstrate qualifying work, education, community service, job training, or other qualifying activities. They can also establish that they qualify for an exemption. Illinois will also begin reviewing eligibility for ACA Adult Medicaid recipients every six months instead of once per year.
These more frequent renewals mean there will be more opportunities for eligible people to lose Medicaid because of missed paperwork, outdated addresses, inaccessible notices, difficulty documenting an exemption, or other administrative barriers.
Disability and New Work Requirements
Many people with disabilities should not have to meet the new Medicaid work requirement.
Federal law provides exemptions for several populations, including certain people with disabilities and significant medical conditions. Exemptions can also apply to people providing care for a person with a disability. But disability and Medicaid eligibility are complicated.
Some disabled Illinoisans receive Medicaid through disability-specific eligibility programs. Others receive Medicaid as ACA Adults because they meet the income requirements but have never been formally determined disabled by Social Security or the Medicaid system.
For example, someone with a chronic illness, psychiatric disability, Long COVID, episodic disability, or another condition may be enrolled as an ACA Adult even though their disability makes working 80 hours per month difficult or impossible.
Do not assume that being enrolled as an ACA Adult means you cannot qualify for a disability or medical exemption.
Likewise, do not assume that because your doctor considers you to be disabled, Illinois already has your information needed to provide your exemption.If you receive a notice saying you are subject to work requirements and you believe your disability, medical condition, or caregiving responsibilities should exempt you, respond to the notice.
Who May Qualify for an Exemption?
Depending on your circumstances, you may be exempt if you:
- have a disability or medical condition that significantly interferes with your ability to meet the requirement;
- have Medicare Part A or Part B;
- care for a person with a disability;
- are pregnant or receiving postpartum Medicaid coverage;
- are a veteran with a qualifying total disability rating;
- participate in a qualifying drug or alcohol treatment program;
- meet applicable SNAP or TANF work requirements;
- are experiencing certain temporary hardships; or
- fall within another exemption established by federal or state rules.
Illinois plans to use information already available to the State to identify exemptions whenever possible. If the State cannot verify your exemption through existing data, you may be asked for additional information.
If you believe you should be exempt, do not give up your Medicaid simply because you receive a work requirement notice.
How Do I Know What Type of Medicaid I have?
Your Medicaid health plan is not the same thing as your Medicaid eligibility category. For example, your Medicaid card may say CountyCare, Aetna, Blue Cross Blue Shield, Meridian, Molina, or another managed care plan. That tells you which health plan administers your benefits, but does not necessarily tell you why you qualify for Medicaid.
You may qualify through an eligibility category such as ACA Adult, Aid to the Aged, Blind or Disabled (AABD), Health Benefits for Workers with Disabilities (HBWD), Family Health Plans, or another Medicaid program.
Check your case
Log into Illinois’ ABE Manage My Case system to review information about your Medicaid benefits and case. If you cannot determine your eligibility category from the information available online, contact the State and ask: “What Medicaid eligibility category am I enrolled under?”
If you are told that you are an ACA Adult, pay particular attention to notices about the 2027 changes.
If you receive disability-related Medicaid or believe you should qualify for a disability-related exemption, keep documentation that may help establish your status.
Protect Yourself From Losing Medicaid
The new rules will increase the amount of paperwork and eligibility verification some Medicaid recipients must complete. For disabled people, especially people with cognitive, intellectual, psychiatric, sensory, or fluctuating disabilities, these administrative requirements can become barriers to healthcare.
There are steps you can take now.
- Create or check your ABE Manage My Case account
Make sure you can log in before you urgently need to respond to a Medicaid notice. - Update your address, phone number, and email
The State cannot help you respond to a notice you never receive. Make sure Illinois Medicaid has an address where you can reliably receive mail. Update your information whenever you move or change phone numbers or email addresses. - Open every Medicaid notice
Do not assume a letter is routine. Beginning in September 2026, Illinois plans to send notices to Medicaid recipients who may be affected by the new requirements. - Know your Medicaid eligibility category
Find out whether you receive Medicaid as an ACA Adult, through a disability-related eligibility category, or through another program. - Keep disability-related documentation
If you have a disability or health condition that may qualify you for an exemption, consider keeping relevant documentation accessible. Depending on the circumstances and future State guidance, documentation could include records or statements from healthcare providers, disability determinations, or other evidence demonstrating how a condition affects your ability to comply with the requirement. - Respond even if you think the State made a mistake
If Illinois asks for information about work requirements or an exemption, respond by the deadline.
A notice saying the State cannot verify your exemption does not necessarily mean you are not eligible for one. - Keep copies
Save copies of forms, notices, medical documentation, confirmation numbers, screenshots, and other materials you submit. If possible, write down when you submitted information and how it was submitted. - Ask for accommodations when you need them
Medicaid agencies and their contractors have obligations under federal disability rights laws. If a disability makes it difficult to complete forms, communicate by telephone, understand notices, access an online portal, or otherwise navigate the Medicaid process, ask for a reasonable modification or accessible communication. Administrative requirements should not become an inaccessible doorway that prevents eligible people with disabilities from receiving services.
What Happens If Illinois Says I Am Losing Medicaid?
Do not assume that a Medicaid termination notice is correct. Read the notice carefully. It should explain:
- Why the State believes your coverage is ending;
- When the change will take effect;
- Whether additional information can be submitted; and
- Your rights to challenge the decision.
If you believe the State has incorrect information, failed to recognize your disability or exemption, or otherwise incorrectly determined that you are ineligible, seek assistance as soon as possible. Pay close attention to appeal deadlines.
Why Are These Changes Concerning For People With Disabilities?
Work requirements are often described as applying to “able-bodied” adults or people who can work. We know that disability does not always fit neatly into government eligibility categories.
A person can have a significant disability without receiving SSI or SSDI. Someone may be waiting for a disability determination. Others have episodic conditions that allow them to work only during some periods. People with psychiatric disabilities, chronic illnesses, Long COVID, or other conditions may have substantial functional limitations that are not immediately visible in government databases.
There are also people with disabilities who work but experience unstable hours, need intermittent leave, lose jobs because appropriate accommodations are unavailable, or move in and out of employment because of their disability. That is why Access Living believes implementation of these requirements must recognize the real experiences of people with disabilities.
Losing Medicaid does not help someone find or maintain employment. For many people with disabilities, Medicaid is what makes employment and community living possible in the first place.
Important Dates
September 2026
Illinois expects to begin sending advance notices to Medicaid recipients who may be affected by the new work requirements.
October 1, 2026
Federal Medicaid eligibility changes begin for some noncitizens.
January 1, 2027
Work/community-engagement requirements begin for affected ACA Adult Medicaid recipients.
January 1, 2027
Six-month Medicaid eligibility reviews begin for ACA Adults.
What Should I Do Right Now?
If you receive Medicaid in Illinois:
- Make sure the State has your correct address, phone number, and email.
- Create or check your ABE Manage My Case account.
- Find out what Medicaid eligibility category you have.
- Open and respond to every Medicaid notice.
- If you have a disability or medical condition, learn whether you qualify for an exemption.
- Keep copies of anything you send to the State.
- Ask for disability accommodations if you need them.
- Get help quickly if you receive a notice saying your Medicaid will end.
Most importantly: Do not voluntarily give up your Medicaid coverage because you hear that the rules have changed. The changes do not affect every Medicaid recipient, and many people with disabilities may qualify for an exemption or may not be subject to the new requirements at all.
Access Living will continue monitoring implementation of the new federal Medicaid requirements and advocating to ensure that people with disabilities in Illinois do not lose healthcare because of inaccessible systems, unnecessary paperwork, or administrative barriers.
Additional Resources
• Federal resource center
• Medicaid changes for beneficiaries