Trump’s 2025 law puts roughly 540,000 New Jersey adults on the NJ FamilyCare expansion plan under a Medicaid work rule, according to guidance the state’s Division of Medical Assistance and Health Services updated on September 10, 2026. The first group affected is members whose renewals fall in March 2027, and the state lists the end of that month as the first date anyone could be disenrolled. The division projects that between 165,000 and 330,000 current members could lose coverage by 2030.
Who sits inside the 540,000
The 540,000 are adults 19 to 64 enrolled under the plan type New Jersey calls the Alternative Benefit Plan, or ABP. The state’s overview of the federal changes says the same group must also renew every six months instead of every 12, starting January 1, 2027.
Members in this group have three things to sort out before January. They need to know whether an exclusion covers them, whether they can show 80 hours a month of work, volunteering, a work program or at least half-time school, and whether the state has a current address on file. The 80 hours can be a mix of those activities, and household income of at least $580 a month also meets the test, with seasonal pay averaged over six months.
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The state’s guidance lists exclusions, meaning people who are not subject to the rule at all. They include anyone on SNAP who is under the SNAP work rules, people meeting the WorkFirst NJ cash-assistance requirement, and parents, guardians or caregivers of a child under 14 or of a person with a disability. Pregnant members and those within 12 months after a pregnancy ends are also out, as are veterans with a 100 percent VA disability rating and members of federally recognized tribes.
A second list covers exceptions. Adults under 19, people enrolled in Medicare, people who receive Supplemental Security Income, patients in inpatient acute care and residents of counties with high unemployment fall there, as do people in a declared disaster area. The guidance adds that the exceptions may not apply to someone recently released from jail or prison.
Medically frail members are excluded too. That covers people who are blind or disabled under Social Security’s definition, people in substance use treatment, and people with a disabling mental disorder or a serious or complex medical condition. Through December 2027 members can attest to frailty without paperwork, and the state says stricter documentation starts in 2028.
Why a March renewal goes first
New Jersey says renewal checks begin about two months before a member’s renewal date. For the March 2027 cohort, that puts the first work-rule reviews in January 2027, the same month the six-month renewal cycle starts.
Current members are checked against any time since their last renewal, so an old stretch of unreported work still counts. New applicants are checked for the month before they apply or the month of application. The state says this lookback is what the renewal reviews will test.
Members the state cannot confirm automatically receive a renewal packet. If more information is needed, a Request for Information goes out, and members have 14 or 30 days to answer depending on their situation. A missed reply is how a paperwork gap turns into a lost card.
The first potential disenrollments fall at the end of March 2027. From that point members have 90 days to send missing information without filing a new application, and the state says answering within about 60 days lowers the risk of a gap in coverage.
How big could the losses get?
The state’s own projection is that between 165,000 and 330,000 current members could lose coverage by the end of state fiscal year 2030, which ends June 30, 2030. Measured against 540,000 expansion adults, that is roughly 31 percent to 61 percent of the group.
An earlier Department of Human Services presentation, built on June 2025 data, put the work-rule losses at up to 300,000 people and the lost federal funding at about $2.5 billion a year. That slide deck counted about 1.85 million New Jersey residents on Medicaid overall. The September guidance is newer and gives the wider range.
The federal law behind all of it is the 2025 budget act, P.L. 119-21. It set the 80-hour standard and the January 1, 2027 start, and New Jersey’s guidance spells out how the state will apply it to its own roster.
Shorter look-back for medical bills
Starting January 1, 2027, retroactive coverage for expansion adults shrinks to one month before the month of application or re-enrollment. All other members get up to two months. Applications filed before that date keep the old three-month rule.
For a member who loses coverage and reapplies late, the shorter window can leave a hospital or pharmacy bill uncovered even inside the 90-day reconsideration period. The state’s guidance warns of that gap directly.
The state also warns about the marketplace. Members who lose coverage for not meeting the work rule cannot get subsidies through GetCoveredNJ if their income would otherwise qualify them for NJ FamilyCare. Anyone who loses coverage for another reason has 60 days to enroll there.
Letters went to expansion adults identified as of August 1, 2026, in early September. The state’s expansion adult hotline, 1-833-409-2370, takes contact updates and questions, and the NJ FamilyCare application line is 1-800-701-0710.
Members on other renewal calendars are checked when their own six-month renewals arrive, so the March group is the first test rather than the only one. Whether a renewal lands in March, or later in 2027, is printed on the member’s own notice.
Is your NJ FamilyCare renewal one of the March 2027 ones?
A March 2027 renewal means the work-rule check starts in January, and a reply that misses its 14 or 30 day window can end in disenrollment at the end of March. After that, members have 90 days to send in what was missing.
The SNAP & Medicaid Renewal Organizer covers the new Medicaid work requirement and who is exempt, with a renewal and reporting calendar and the 90-day window after coverage is dropped. Its 51 state packs include one for New Jersey, so the dates sit in one place.
Get the Medicaid renewal organizer with the work-rule exemptions and calendar →
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This article was produced with AI assistance and edited for accuracy against the sources linked above.
