Medicaid Work Requirements in Missouri
Missouri's requirement for the Adult Expansion Group starts January 1, 2027. The Family Support Division checks one qualifying month and gives 35 calendar days to respond to a noncompliance notice.
Check your situation in Missouri
When it starts in Missouri
- October 2026: DSS released an H.R. 1 toolkit and its Community Engagement Screening Tool.
- January 1, 2027: the requirement starts.
Who has to meet it
The rule applies to people ages 19 to 64 in the MO HealthNet Adult Expansion Group (AEG), unless they are pregnant, have Medicare, or are exempt. You meet it in a month with 80 hours of work, community service, a work program, or school (in any mix), by going to school at least half-time, or with at least $580 in monthly income.
You are exempt if, for example, you care for a child 13 or younger or a person with a disability, are pregnant or postpartum, are American Indian or Alaska Native, are medically frail, are a veteran with a total (100%) VA disability rating or TDIU, were in foster care at 18 and are under 26, are in drug or alcohol treatment, meet SNAP or TANF work rules, or left jail or prison in the last 3 months. See the full exemption list.
Court ruling, October 29, 2026. In Massachusetts v. Oz, a federal court struck down the CMS rule's extra "significantly impairs" test for the medically frail exemption. If you are in any of the five medically frail groups in the law, you qualify. The January 1, 2027 start date did not change, and CMS may appeal. What the ruling means.
How Missouri checks and how to report
Months checked: One qualifying month. For applicants, the month before applying. For members, any one month since the last renewal. Hours do not carry over from month to month.
Do not send anything until the Family Support Division asks. When asked, upload documents in myDSS, or mail, fax, or bring them to an FSD Resource Center.
Other things to know in Missouri
- A DSS spokesperson told KCUR that members must show compliance for at least one month in each 6-month eligibility period.
- FSD first checks information it already has and sends a letter only if it cannot verify something.
- Missouri's Medicaid expansion is in the state constitution (2020 Amendment 2).
Official tools and contacts
- Check if it applies: Community Engagement Screening Tool
- Report and upload: myDSS
- FSD Information Center (MO HealthNet eligibility): 1-855-373-4636
- MO HealthNet Constituent Services: 1-800-392-2161
- TDD/TTY: 1-800-735-2966
- DSS: community engagement requirements FAQ
- FSD Resource Centers
- Agency: Missouri Department of Social Services, Family Support Division
Federal protections that apply in Missouri
- The state must check its own records before asking you for proof.
- If it can't confirm you meet the rule, you get a notice and at least 30 days to respond, and your coverage continues meanwhile.
- You get written notice and the right to a fair hearing before coverage ends, and you can reapply at any time.
- If you lose Medicaid for not meeting the rule, you cannot get marketplace premium tax credits for those months. Learn more.
Frequently asked questions
When do Medicaid work requirements start in Missouri?
January 1, 2027. Current members are usually checked at their first renewal on or after that date.
How many months does Missouri check?
One qualifying month. For applicants, the month before applying. For members, any one month since the last renewal. Hours do not carry over from month to month.
How do I report my hours or an exemption in Missouri?
Do not send anything until the Family Support Division asks. When asked, upload documents in myDSS, or mail, fax, or bring them to an FSD Resource Center.
Who do I call about MO HealthNet work requirements?
FSD Information Center (MO HealthNet eligibility): 1-855-373-4636
MO HealthNet Constituent Services: 1-800-392-2161
TDD/TTY: 1-800-735-2966
Can I lose MO HealthNet right away if I don't meet the requirement?
No. Federal law requires a notice, at least 30 days to show you comply or are exempt, continued coverage during that time, and fair hearing rights before coverage ends.
Sources
- Missouri DSS: community engagement requirements FAQ
- Missouri DSS: toll-free numbers
- KCUR (Oct. 26, 2026)
- Public Law 119-21 (H.R. 1), sec. 71119: community engagement requirement (GovInfo)
- CMS interim final rule, Medicaid community engagement requirement, 91 FR 33348 (June 3, 2026)
- Massachusetts v. Oz, No. 1:26-cv-12962-RGS (D. Mass.), memorandum and order (Oct. 29, 2026)