Community Resource
Medicaid changes in Illinois: what to know
A new federal law, H.R. 1, changes some Illinois Medicaid rules. Many people are not affected, and most changes start in 2027. Here is what the State of Illinois says, and where to get official help.
The State says no one will be required to act until they receive direct notice from the State. Keep your contact information up to date and open mail from the State of Illinois right away.
What is changing
Work requirements for some adults
Starts at your first renewal on or after January 1, 2027. People who apply after December 31, 2026 are also included.
Who it applies to: "ACA Adults," generally people ages 19 to 64 who have no dependent children under 18 at home and are not on Medicare.
How to meet it: monthly income of $580 or more, or 80 hours a month of work, volunteering, school or a work program. Hours can be combined. Half-time students also meet the requirement.
Who is exempt includes: pregnant people and people in the 12 months after giving birth, veterans with a 100% disability rating, American Indians and Alaska Natives, former foster youth under 26, caregivers of a young child or of a dependent with a disability, people with a qualifying medical condition, people in drug or alcohol treatment, and people incarcerated or released in the last 3 months. The State's guide has the full list.
Renewals every six months
After their first renewal in 2027, ACA Adults will need to renew their Medicaid every six months, including people who are exempt from work requirements.
Changes for some noncitizens
Some noncitizen eligibility changes took effect October 1, 2026. Lawful permanent residents (subject to federal waiting rules), Cuban and Haitian entrants, COFA citizens, lawfully residing children under 19 and lawfully residing pregnant people remain eligible. The State's guide explains who is affected.
Who is not affected by the work requirements
People under 19 or over 64, people enrolled in or entitled to Medicare, and people in other Medicaid groups such as AABD, Moms and Babies, and FamilyCare.
What you can do now
- Update your address, phone and email through ABE or the Medicaid Address Change Form.
- Open mail from the State of Illinois right away.
- Create or log in to Manage My Case on ABE to see your renewal date and notices.
- Keep proof of your work or activity hours, or of an exemption.
- Not sure if you are an ACA Adult? Call Illinois HFS at 1-877-805-5312.
Official resources
Illinois Medicaid Customer Guide to H.R. 1 Changes
Opens in a new tabIllinois HFS: Frequently asked questions
Opens in a new tabABE: Manage My Case
Opens in a new tabMedicaid Address Change Form
Opens in a new tabGet Covered Illinois
Opens in a new tabMedicaid: Get the Facts, from Cook County Health, with an eligibility quiz and one-page guides in 14 languages
Opens in a new tabHow to avoid Medicaid scams, from Cook County Health
Opens in a new tabEn español: Preguntas frecuentes · Guía de elegibilidad
About this page
Prism Health shares this information as a community resource. We do not work for or speak for any state agency, and we cannot decide anyone's eligibility. For questions about your case, contact Illinois HFS at 1-877-805-5312. If you visit a Prism Health event, our team can help you find these official resources.
Information from Illinois HFS, reviewed November 5, 2026. Rules may change; check hfs.illinois.gov for the latest. Some resources on this page are from the Cook County Health Medicaid Impact Workgroup.