CHARLESTON, WV (LOOTPRESS) – A newly introduced bill in the West Virginia Senate would significantly change how the state’s Medicaid program operates, adding work requirements, stricter eligibility checks, and new cost-sharing rules for some recipients.
Senate Bill 729, introduced during the 2026 Regular Legislative Session, sets mandatory program requirements designed to bring West Virginia’s Medicaid system into compliance with federal standards outlined in the One Big Beautiful Bill Act, signed into law in 2025. The bill has been referred to the Senate Committees on Health and Human Resources and Finance.
Under the proposal, the Bureau for Medical Services would be required to implement a Medicaid work requirement for enrollees by January 1, 2027. The bill would also prohibit individuals living in the United States illegally from receiving Medicaid benefits by October 1, 2026.
Additional provisions include mandatory eligibility verification at least twice a year, a ban on multi-state Medicaid enrollment, and quarterly removal of deceased individuals from Medicaid rolls. The bill also sets deadlines to reduce the Medicaid error rate to three percent or less by 2028 .
The legislation would further limit how far back Medicaid coverage can be applied retroactively and would require cost-sharing for adults enrolled through Medicaid expansion by October 2028. All Medicaid waivers would be required to remain budget-neutral under the bill.
Supporters argue the proposal would improve accountability, reduce waste, and ensure Medicaid resources are directed to eligible recipients. Critics are expected to raise concerns about potential coverage losses for low-income residents.
The bill is still early in the legislative process and would require federal approval from the Centers for Medicare and Medicaid Services before many of the changes could take effect.
