Medi-Cal 新规2027年上路：19至64岁扩展组成员每月须工作满80小时、续期改半年一次
位于加州圣贝纳迪诺县的县健康与公众服务部门 10 月 29 日发布说明，提醒全县 Medi-Cal（加州医疗补助）成员：依据联邦 H.R.1 法案的新规将从 2027 年起分阶段上路，19 至 64 岁「成人扩展组」成员的资格条件会有明显变化，县府请成员提前了解、并保持联系方式与住址信息为最新。
新规的核心是工作与社区参与要求：扩展组成员每月须完成 80 小时的有偿工作、社区服务或类似参与；达不到时数门槛的，也可通过其他方式满足条件，例如每月收入不低于 580 美元、半日制在学，或工作与在学的组合。
多类人群获得豁免，包括孕妇、13 岁及以下儿童的照护者、残障人士、美洲原住民等，具体名单以县府说明为准。此外，成员的资格续期将从现在的一年一次改为每 6 个月一次，错过续期材料可能导致保障中断。
时间安排上，新申请者自 2027 年 1 月 1 日起按新规审核；现有成员则自 2027 年 3 月起在续期时适用。县府表示，将通过邮件与社区渠道陆续通知受影响的成员，并提醒成员收到县府信件务必及时打开、按期回复，以免保障被中止。圣迭戈等其他县也已陆续发布各自的说明，规则细节以成员所在县的通知为准。
New Medi-Cal Rules Take Effect in 2027: 80 Hours a Month of Work and Renewals Every Six Months for Expansion Adults
San Bernardino County's human services department, in California, published guidance on October 29 telling the county's Medi-Cal members that new rules under the federal H.R.1 law will phase in from 2027, bringing significant eligibility changes for members aged 19 to 64 in the adult expansion group. The county is urging members to learn the rules early and keep their contact and address information current.
The centerpiece is a work and community engagement requirement: expansion adults must complete 80 hours a month of paid work, community service or similar engagement. Those who cannot meet the hours threshold can also qualify another way — for example, monthly earnings of at least $580, enrollment at least half-time in school, or a combination of work and school.
Several groups are exempt, including pregnant women, caregivers of children aged 13 and under, people with disabilities and Native Americans; the county's guidance carries the full list. In addition, eligibility renewals will move from once a year to every six months, and missing renewal paperwork could interrupt coverage.
On timing, new applicants will be reviewed under the new rules starting January 1, 2027, while current members will be subject to them at renewal starting in March 2027. The county said affected members will be notified by mail and community channels, and members should open county letters promptly and respond on time to avoid losing coverage. Other counties, including San Diego, have begun issuing their own guidance; members should follow the notice from their own county.
来源：GSM·美国（原文链接）
图片来源：图：位于 Colton 的圣贝纳迪诺县县立 Arrowhead 区域医疗中心（资料图）。图片：经 Wikimedia Commons。 / Arrowhead Regional Medical Center, the county hospital in Colton (file photo). Via Wikimedia Commons.
