Paraquad Urges Missourians with Disabilities to Prepare Now for New MO HealthNet Requirements
Major MO HealthNet changes are approaching, and Paraquad is urging Missourians with disabilities, families, caregivers, and advocates to prepare now by understanding the new requirements, reading official notices carefully, and speaking up if new barriers threaten access to health care or essential supports.
Beginning January 1, 2027, new federal Medicaid requirements will change the eligibility and renewal process for many Missouri adults covered through the state's Medicaid expansion program, including new community engagement requirements and more frequent eligibility reviews. The scale of the change is significant: the Missouri Department of Social Services is sending informational notices to more than 300,000 MO HealthNet participants who may be affected by the new community engagement requirements.
Paraquad has serious concerns about what these changes could mean for people with disabilities, particularly whether new administrative and documentation requirements could create additional barriers between eligible Missourians and the health care and essential services they rely on.
People with disabilities or qualifying medical conditions, as well as caregivers of people with disabilities who meet exemption criteria, may not be subject to the new community engagement requirements. However, determining whether an exemption applies may require additional information or documentation. Paraquad is concerned that the exemption process could create confusion, paperwork burdens, or accessibility barriers for eligible Missourians trying to demonstrate that they qualify.
“People with disabilities already navigate systems that can be complicated and difficult to access,” said Colleen Burdiss, Independent Living Specialist and advocate at Paraquad. “Adding more frequent reviews, verification requirements, and another process to demonstrate an exemption creates real concern. An exemption should provide a clear pathway for people who qualify—not become another barrier between them and the health care and supports they need to live independently.”
These concerns extend beyond the disability community. Disability is something that touches all of us—through our families, our friends, our neighbors, and our communities. For any of us, a change in life circumstances, a medical diagnosis, a stroke, an accident, or a mental health crisis can change what we need and how we live. For many of us, disability is not a question of if, but when. Ensuring that people can access the health care and supports they need is a concern that belongs to all of us.
“This is about preparation, organizing, and demonstrating the power of our disability community and the people who stand with us,” said Latosha R. Fowlkes, LCSW, President and CEO of Paraquad. “Our message is clear: policy decisions have real consequences, and the people who will live with those consequences must be part of the conversation. For individuals with documented disabilities that do not change, repeated eligibility reviews can waste both people's time and state resources while creating unnecessary risk of coverage disruption.”
Among the upcoming changes, adults covered through the Adult Expansion Group will move from annual eligibility reviews to reviews every six months. Adults subject to the new requirements will generally need to demonstrate that they met the community engagement requirement during a qualifying month. Qualifying pathways include completing at least 80 hours of work, community service, certain work programs, or a combination of activities; enrolling in an educational program at least half-time; or earning income that meets the federal requirement. Individuals who meet certain exemption criteria will not be subject to the community engagement requirements.
If the state cannot verify that an individual has met the requirement or qualifies for an exemption, the individual must be notified and given an opportunity to provide additional information. Paraquad is particularly concerned that these processes be clear, accessible, and designed so that eligible people do not lose coverage because of administrative barriers.
As Missouri prepares to implement the new requirements, MO HealthNet participants are beginning to receive informational notices. Receiving a notice does not mean a person's coverage is ending, and individuals receiving the current notice do not need to submit community engagement or exemption information at this time. Paraquad encourages MO HealthNet participants to prepare now by taking the steps outlined below.
Steps MO HealthNet participants can take now:
Make sure your contact information is current with the Missouri Family Support Division, including your mailing address, phone number, and email address. Review the household members listed on your notice and contact the Family Support Division if any information is incorrect.
Sign up for and regularly check your MO HealthNet or Medicaid online portal account, if available. The portal can help you stay updated, see whether documents are needed, and receive reminders when it is time to renew or take action.
Open and read every notice you receive from MO HealthNet or the Family Support Division, even if it appears informational.
Keep copies of notices and records that may help document employment, education, community service, other qualifying activities, or reasons you may qualify for an exemption.
Do not submit community engagement or exemption documentation in response to the current informational notice unless the Family Support Division specifically asks you to do so.
Ask for help if you need it. If a notice or process is confusing or inaccessible, seek assistance rather than ignoring it.
“We do not have to wait for people to lose coverage before raising concerns about what these changes could mean,” Fowlkes said. “Now is the time to prepare, ask hard questions, and make sure our disability community is at the table. If barriers emerge, we must be ready to show what is happening in our lives and advocate for change.”
In the months ahead, Paraquad will continue listening to our disability community, documenting barriers as they emerge, monitoring implementation, and bringing those experiences and concerns directly to policymakers in Jefferson City. Paraquad will also share opportunities for people with disabilities, families, caregivers, advocates, and members of the wider community to join these efforts.
Community members can also sign up for Paraquad advocacy updates and connect with the St. Louis Chapter of People First to build self-advocacy skills and engage in disability-led advocacy.
Prepare now. Stay informed. Speak up. Paraquad urges Missourians with disabilities, families, caregivers, and advocates to prepare for upcoming changes, share barriers as they emerge, and help bring the disability community's concerns to Jefferson City.