What Medicaid Recipients Should Know About The ‘One Big Beautiful Bill’

Nearly $1 trillion will be cut from the Medicaid program over the next decade now that the “One Big Beautiful Bill” has been signed into law.

These cuts will be the largest ever to the program, according to the Center on Budget and Policy Priorities. Experts estimate that almost 12 million recipients will be without health care coverage over the next 10 years.

Here is what America’s over 71 million Medicaid recipients need to know about the bill.

Changes To Who Is Eligible

The bill changes who is eligible to receive Medicaid. It requires “able-bodied” recipients to work, volunteer, or go to school at least 80 hours per month if they are between the ages of 19 and 64. 

Those who are disabled, pregnant, or caring for a child younger than 14 will be exempt.

Recipients will also be required to verify their eligibility twice a year, whereas they only currently need to do so once.

Retroactive Coverage Will Be Limited

States currently cover Medicaid benefits retroactively for three months before an eligible individual signs up for coverage. But the One Big, Beautiful Bill shrinks that window to just one month, according to health care think tank KFF.

There Will Be Changes in Care

Medicaid is the biggest source of funding for long-term care for disabled and elderly people. It covers more than half of the $415 billion spent on these services every year, according to KFF.

Without federal funding for Medicaid, many nursing homes would have to rely on more state funding to stay open. But many states don’t have room in the budget to help, which could force some facilities to close. 

Those that don’t, however, will likely be overwhelmed, forcing more seniors to visit hospitals or emergency rooms for care. Many of these hospitals are also heavily funded by Medicaid, which means that care for everyone–not just those covered under Medicaid–could be impacted.

A new program, the Rural Health Transformation Program, was created to help rural areas of America that will be hit hard by the Medicaid cuts. The program will allocate $10 billion across all 50 states for five years, according to the Bipartisan Policy Center, and will be implemented starting in 2026.

The program, however, won’t be enough to offset the Medicaid cuts hitting rural America, some hospital executives say. 

Millions of sick and disabled people also rely on family members to take care of them. If these caretakers don’t have enough time to take another job, per the new eligibility requirements, they might lose their own Medicaid coverage.

The Big Beautiful Bill also strips Planned Parenthood of any Medicaid funding for women’s health care. While Medicaid generally cannot be used to cover abortions (except in certain cases), it can be used for contraception, cancer screenings, wellness exams, and other preventative care that Planned Parenthood offers. 

Medicaid Recipients Will Have Co-Pays For Services

States will be required to impose co-pays of up to $35 for medical services on people with incomes more than 100% of the federal poverty level. In 2025, that’s $15,650 for individuals and $32,150 for a family of four.

The law does include exceptions for certain types of health care providers. It also allows providers to turn away patients who cannot afford the co-pay for medical services.

State Budgets Will Tighten

Under the Big Beautiful Bill, states will be responsible for more of the costs of operating the Medicaid program–costs that currently come from federal funding.

“Very few of these states are going to have the resources to replace the federal money that they lose, so they’re going to be forced, in many cases, to redefine who is eligible for the program,” Maria Freese, senior legislative representative at the National Committee to Preserve Social Security and Medicare, previously told Investopedia.

The bill also curtails provider taxes, which every state except for Alaska currently uses to help fund their Medicaid programs.

A provider tax is a health care-related fee, assessment or other mandatory payment where at least 85% of the burden of the tax revenue falls on health care providers. States can levy taxes and assessments on a variety of provider types, like hospitals and nursing facilities in order to help fund Medicaid.

Maximum Home Equity Levels Will Also Take Effect

Under the bill, Medicaid applicants will not qualify if their home equity is valued at more than $1 million. That figure is not eligible to be adjusted for inflation.

There are currently state-determined maximum limits on home equity, which fall between $730,000 and $1,097,000, and are indexed to inflation.

This means that if an individual resides in a home valued above $1 million, even if they don’t make enough money to sustain themselves, they will be considered ineligible for Medicaid.

“This change will be particularly harmful in states with higher property values like California, New York, Massachusetts, New Jersey, and Washington,” said Dan Adcock, director of government relations and policy at the National Committee to Preserve Social Security and Medicare.