Rialto residents on Medi-Cal may soon need to prove they work, volunteer or attend school to keep their health coverage. Starting in 2027, certain adults must log at least 80 hours of qualifying activity a month.

San Bernardino County posted an outreach notice Oct. 29 urging members to prepare for new federal requirements tied to H.R. 1, the reconciliation law Congress passed last year. The rules apply to adults ages 19 through 64 who receive Medi-Cal through the Affordable Care Act (ACA) expansion, a group the state calls the New Adult Group.

Not all Medi-Cal members will be affected. The California Department of Health Care Services (DHCS) is sending information to members who may be impacted, according to the county.

Two deadlines to know

Certain new applicants will be evaluated for the Work and Community Engagement Requirements (WCER) starting Jan. 1, 2027. Current members will see changes begin in March 2027. Members will receive notices explaining what applies to them and whether they need to submit additional information.

Affected members must also renew their Medi-Cal eligibility every six months instead of once a year. A current New Adult Group member who completes a renewal in March 2027, for example, would face another review in September 2027, according to the county. Being excused from the work requirement does not automatically excuse a member from the six-month renewal schedule.

What counts toward 80 hours

The county listed several ways to meet the requirement:

  • Working at least 80 hours a month, including paid, self-employed or in-kind work
  • Volunteering or completing community service for at least 80 hours a month
  • Participating in a qualifying job-training program for at least 80 hours a month
  • Attending school at least half-time
  • Earning a monthly income of at least $580, calculated at 80 hours at the federal minimum wage
  • Combining any of the above to reach 80 hours

Additional options may apply to seasonal workers or people whose income or hours fluctuate, the county said.

Who is exempt

Several groups can be excused from the work requirement, according to the county:

  • People who are pregnant or receiving postpartum care
  • Parents or caretakers of children age 13 or younger
  • People with medical conditions or disabilities that prevent them from meeting requirements
  • People with Medicare coverage
  • American Indian or Alaska Native individuals
  • Certain former foster youth younger than 26

The county said it will review available information and determine whether members must meet the requirements or qualify for an exemption.

Broader context

The policy applies nationally. Healthcare Dive reported in October 2026 that five governors, including California Gov. Gavin Newsom, sent a letter to Health and Human Services Secretary Robert F. Kennedy Jr. asking for more time to comply. The governors argued that a federal interim final rule released in June included stricter provisions than states had expected, making the Jan. 1, 2027, deadline difficult to meet. Healthcare Dive reported no federal response as of mid-October.

A KFF analysis published Oct. 7 found that 44 states must implement the new work requirements. The Congressional Budget Office estimated the reconciliation law would reduce federal Medicaid spending by $911 billion over the 2025–2034 period and increase the number of uninsured people by 7.5 million in 2034, according to KFF.

What Rialto residents should do now

The rules keep changing. In an August CalMatters report, Jack Dailey, director of health policy at the Legal Aid Society of San Diego, stressed the importance of staying alert. "It's so vital they watch the mail, look out for communications from the county, and are responsive to requests for information," Dailey said.

The county urged members to keep their mailing address, phone number and email current, check mail and online accounts regularly for notices, and return renewal forms by stated deadlines.

Members can manage their benefits, upload documents and review notices online through BenefitsCal. Current members face their first deadline in March 2027.