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AASD and DSD eList announcement

Date: Aug. 13, 2026
To: Lead agencies and other interested parties
From: DHS Aging and Adult Services and Disability Services divisions
Purpose: To announce how federal changes to Medical Assistance (MA) will affect people who use waivers, Alternative Care (AC) and personal care assistance (PCA)/Community First Services and Supports (CFSS)
Effective: Oct. 1, 2026
Contact: Refer to the resources section below.

Changes to MA eligibility for certain noncitizens

Federal law changed who can qualify for MA and AC based on immigration status. Beginning Oct. 1, 2026, MA and AC eligibility for noncitizen adults age 21 and older who are not pregnant is limited to Lawful Permanent Residents, Cuban or Haitian entrants and Compact of Free Association (COFA) migrants. People with any other immigration status will no longer qualify for MA or AC.

Counties and Tribal Nations should review information in this eList to prepare for upcoming eligibility changes and provide support to the people they serve.

DHS – Timeline of direct enrollee communications provides information about DHS’ communication efforts beginning in June 2026, including:

· MA mailer (PDF).

· MA changes on Oct. 1, 2026, affecting certain noncitizen adults (PDF).

· One-time text messages.

How does this change affect people who use home and community-based services (HCBS) waivers/AC?

People without an MA-eligible immigration status will no longer have their waiver/AC services covered starting Oct. 1, 2026. Their case manager will send them a notice of action to end waiver/AC services. Managed care organizations have their own notice of action process.

DHS has identified about 200 people who access HCBS waiver/AC services who will be affected by this federal law change. DHS will share the list of impacted people with counties and Tribal Nations via secure email. If a county/Tribal Nation is aware of an enrollee’s immigration status change or that an enrollee is pregnant, the county/Tribal Nation can share that information with the county/Tribal Nation financial worker.

Counties and Tribal Nations can share the resources in this eList with noncitizens who receive HCBS waiver/AC services.

How does this change affect people using PCA/CFSS who are not on a waiver?

People without an MA-eligible immigration status will no longer have coverage for PCA/CFSS services starting Oct. 1, 2026.

DHS has identified approximately 90 people who access PCA/CFSS who will be affected by this federal law change. DHS will share the list of impacted people with counties and Tribal Nations via secure email. If a county/Tribal Nation is aware of an enrollee’s immigration status change or that an enrollee is pregnant, the county/Tribal Nation can share that information with the county/Tribal Nation financial worker.

Counties and Tribal Nations can share the resources in this eList with noncitizens who receive PCA/CFSS. If a person does not have a case manager, they can still use the resources in this eList.