“How many of you are currently navigating care for a loved one?”
That’s the question Ai-jen Poo, president of National Domestic Workers Alliance, asked a room full of seniors and caregivers last week at the 48th annual New Mexico Conference on Aging.
Hundreds of hands went up in response. Many more rose when Poo asked people in need of caregiving to identify themselves, too.
“It is the majority of this room, and it is also the majority of our country,” she said. “We are the caring majority of America.”
But some caregivers — in New Mexico and across the U.S. — are going to have to overcome another hurdle, once new Medicaid work and community engagement requirements go into effect Jan. 1. Under the new rules, many New Mexicans ages 19 to 64 will have to complete at least 80 hours of work, school or volunteering per month to maintain their benefits.
People over 65 won’t be subject to the new work requirements, but that doesn’t necessarily mean they’ll be unaffected by them. As the new work requirements go into effect, New Mexico Aging and Long-Term Services Secretary Emily Kaltenbach said people caring for older adults are going to have questions: “Is caregiving considered work? And in what circumstances? And for whom?”
The answer: potentially.
Parents and caregivers may qualify for an exemption to the Medicaid work rules if they’re caring for a child under 14 years old or for a person with a disability, wrote Tim Fowler, a spokesperson for the Health Care Authority, the state agency that administers Medicaid. Rules from the U.S. Centers for Medicare and Medicaid indicate a “disabled individual” can include a senior who needs help with the activities of daily living, like bathing, getting dressed and using the bathroom.
Fowler added the Health Care Authority in 2027 will use existing relationship information and self-attestations to confirm caregivers’ efforts and verify their exemption.
Still, advocates worry caregivers may not be able to wade through additional red tape to keep Medicaid coverage, even if they’re eligible.
“Particularly if you’re an elder or a senior who is a caregiver, you can only manage so much,” said David Davis, founder and executive director of the Santa Fe-based Memory Care Alliance.
He continued, “When somebody is so engaged in caring for someone just on the day-to-day level, getting them out of bed, getting them dressed, getting them fed, getting their medications done, let alone trying to manage their own care … they’re not going to pursue remedies. They don’t have the capacity, particularly when it’s uncertain, when it’s confusing, when it’s difficult.”
The Health Care Authority has already started alerting Medicaid beneficiaries about the changing work requirements, which stem from the One Big Beautiful Bill Act, a massive federal spending and tax bill signed into law last year. The state agency has since September been sending out turquoise envelopes, alerting customers that they need to provide more information to maintain their enrollment.
The Health Care Authority has anticipated some 89,000 of the more than 800,000 New Mexicans who rely on Medicaid will lose coverage as a result of the new work and community engagement rules.
Some of the people subject to the new work requirements will likely be caregivers: AARP has estimated more than 7 million family caregivers across the country are under 65 and rely on Medicaid for their health coverage, particularly since caregivers often sacrifice their income to aid family members.
Megan O’Reilly, vice president for health and family on AARP’s government affairs team, in July wrote a letter to the U.S. Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz, calling for the agency to recognize family caregivers as the “backbone of long-term care in this country” and strengthen the exemptions for which they might qualify.
“AARP is very concerned that under the new requirements, many Americans could lose coverage, not because they are not eligible for Medicaid, but because of administrative barriers and red tape,” O’Reilly wrote.
Kaltenbach said those worries are likely to trickle down to New Mexico seniors and their caregivers, too.
“There’s going to be a lot of, unfortunately, uncertainty. For a lot of families, a lot of fear,” she said.
Though she noted the state Health Care Authority is the expert on all things Medicaid, Kaltenbach said the Aging and Long-Term Services Department will train staff in its Aging and Disability Resources Center about how the Medicaid work requirements may affect the families they serve
“There is going to be a lot more information rolling out across New Mexico over the next couple months on this,” Kaltenbach said. “I don’t want to speak for the HCA and their plans, but we’re standing by their side as a solid partner to be able to communicate to the older adults and caregivers who may not have the information they need or have questions.”
About Medicaid work requirements
New Medicaid work and community engagement requirements will go into effect Jan. 1. Under the new rules, many New Mexicans ages 19 to 64 will have to complete at least 80 hours of work, school or volunteering per month to maintain their benefits.
Some groups are exempt from the work requirements. You do not need to meet work rules if you are:
- Former foster youth under 26.
- American Indian or Alaska Native.
- A parent or caregiver of a child age 13 or younger.
- A caregiver for a person with a disability.
- A veteran with 100% disability.
- Medically frail or have special medical needs.
- Required to meet TANF or SNAP work rules.
- In a drug or alcohol treatment program.
- In jail or prison.
- Pregnant or receiving postpartum care.
To learn more about the work and activity requirements that will affect New Mexico Medicaid customers starting in January 2027, visit hca.nm.gov/keepyourbenefitsnm/.
Margaret O’Hara reports on issues affecting healthy communities in New Mexico. Her work is funded by a grant from Anchorum Health Foundation. Anchorum will not have any role in editorial decisions. The New Mexican and its Public Service Journalism Fund retain full editorial control. Philanthropically funded stories by The New Mexican are made available to all readers without a paywall.
