Kentucky Medicaid work rule starts in 2027: who is exempt

Starting January 1, 2027, some Kentucky Medicaid adults ages 19 to 64 must show work or community activity to keep their coverage. Many waiver families are exempt, including people with a disability and parents caring for a child 13 or younger.

What's changing

The Kentucky Health Benefit Exchange (KHBE) has a new page on the Medicaid work and community engagement requirement. It says:

"Starting January 1, 2027, some adults ages 19 to 64 will need to meet a new work or community engagement requirement"

That is from KHBE's Medicaid Work and Community Engagement page.

To meet the requirement, a person needs one of these:

• At least 80 hours a month of work, job training, volunteering, or school (half-time or more), or
• At least $580 a month in earnings.

Current members must show qualifying activity, or an exemption, for three of the six months before their renewal date.

For 2027 only, you can fill out and sign the MACE forms yourself. No outside signatures are needed:

• MACE-100: activity
• MACE-200: medical exemption
• MACE-300: short-term hardship

If Medicaid thinks someone is not meeting the requirement, they get a notice. They have 30 days to send information, and they keep their coverage during that time. They can also appeal.

Kentucky Medicaid began mailing notices about this to current members on July 1, 2026.

Who it affects (and who it doesn't)

This affects adults ages 19 to 64 who are on Medicaid through Medicaid Expansion, which means they qualify based on income. That can include parent caregivers whose own coverage is income-based.

These people are exempt, according to the page:

• A person of any age with a disability
• People who get Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI)
• People who are medically frail, including people with serious or complex medical and mental health conditions
• Pregnant members, and members in the 12 months after pregnancy
• A parent, guardian, or caregiver actively involved in the care of a child 13 or younger
• Other groups listed on the KHBE page

It also does not apply to children, or to people on Medicaid through a disability-linked category.

Key dates

• July 1, 2026: Kentucky Medicaid began mailing notices to current members.
• January 1, 2027: The requirement begins.

What you can do

1. Check each adult in your home against the exemption list above.
2. If an exemption applies, the page says Medicaid will first check the information it already has. It will contact you if it needs more. Open every letter from Medicaid right away.
3. If you are asked about a medical exemption, the MACE-200 form can be self-attested for 2027. That means you can sign it yourself.
4. If you get a notice saying you are not meeting the requirement, answer within 30 days. Your coverage continues during that time, and you can appeal.
5. Keep a copy of every form you send and every notice you get.

For questions and help, call:

• kynect: 1-855-459-6328, or visit the Medicaid Work and Community Engagement page
• Department for Community Based Services (DCBS): 1-855-306-8959