Pushback on healthcare provisions in the One Big Beautiful Bill Act could mean some don’t go forward as planned, particularly those having to do with Medicaid. Lawmakers and others are now working toward rolling back those provisions.
The changes
“The Medicaid changes are aimed mainly at the states or tightening eligibility,” said Rich Daly, a senior editor with the Healthcare Financial Management Association. “The big change is a new requirement to work, go to school or volunteer part-time each month.”
Patients also may need to provide additional paperwork to prove they qualify for Medicaid, Daly said.
“Overall, it’s going to be more work to get on or stay on the program,” he said.
The pushback
Pushback on Medicaid provisions began just after the One Big Beautiful Bill Act was signed on July 4. Several bills were introduced in the immediate aftermath, including one by Sen. Josh Hawley (R-Mo) aimed at eliminating provisions on how states get federal matching money and increase funding for rural providers.
“Those new bills would roll back several of the provisions within the new law,” Daly said.
Time will tell
Several provisions don’t go into effect until 2027 or later, including work requirements for Medicaid as well as a requirement for Medicaid patients to pay copays for non-emergency services.
For patients who get healthcare coverage through the Health Insurance Marketplace, “passive enrollment” will no longer be in effect, meaning families will need to re-enroll each year.
“It’s going to be more work and more money for those who get public healthcare benefits,” Daly said.
The change in presidential administration following the 2028 presidential election could change those provisions that go into effect later, but Daly said the current administration is unlikely to make changes during its tenure.