07/21/2026
News: For Immediate Release
HHS preparing to implement federal work requirements and other changes to Medicaid program.
View the FULL RELEASE online: hhs.nd.gov
Bismarck, ND (July 21, 2026) - North Dakota Health and Human Services (HHS) is preparing to implement several federally required changes to the state’s Medicaid program over the next two years, including work requirements for some Medicaid Expansion members.
Starting Jan. 1, 2027, adults ages 19 to 64 enrolled in Medicaid Expansion will be required to participate in work, an approved work or training program, volunteer or be enrolled in an education program for at least 80 hours per month to maintain their coverage, unless they qualify for an exclusion.
The new rules exclude certain individuals from having to meet work requirements, including Native Americans; parents, guardians or family caregivers of children ages 13 and under or to someone with a disability; people with special health needs that make it hard to work; pregnant women or members who were pregnant in the last 12 months; and veterans with a 100% disability rating, among others.
“It’s important for our Medicaid Expansion members to know about these upcoming changes so they can prepare,” said HHS Interim Medicaid Director Krista Fremming. “I encourage members to make sure their mailing address, phone number and email address are up to date in our system, so they receive important information about their coverage.”
Most members will have their work requirements verified automatically using federal income data and other approved data sources. Members whose work requirements cannot be verified through these sources will be sent a letter requesting more information. HHS’ preliminary data shows that nearly half of North Dakota’s roughly 23,000 Medicaid Expansion members qualify for an exclusion. The new work requirements are estimated to affect about 5,000 to 7,000 members.
“We are working to make the reporting process as simple as possible for Medicaid Expansion members, as we want all members who qualify to stay covered,” Fremming said.
In the coming months, HHS, in partnership with Blue Cross Blue Shield of North Dakota (BCBSND), will be sending text and email messages to expansion members who have chosen to receive electronic communications, along with mailed letters in late August to raise awareness about the upcoming work requirements. BCBSND is the contracted administrator of the state’s Medicaid Expansion program.
HHS has created a webpage at hhs.nd.gov/StayCoveredND with information about work requirements and how members can update their contact information.
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