Lawfully present immigrants — including refugees, asylees, and humanitarian parolees — are ineligible for Medicare
Potential Impact —Reduced visits or an increase in uncompensated care as people lose access to coverage.
Timeline Stories
All timeline stories.
Temporary 2.5% payment increase under the Medicare PFS ends
Potential Impact — An end to short-term relief from ongoing reimbursement challenges.
Temporary 2.5% payment increase under the Medicare PFS ends Read More »
Around January 22: Possible sequestration of Medicare funds due to OBBBA’s effect on federal deficit
Potential Impact — May lead to automatic cuts to Medicare of roughly $500 billion from 2026 to 2034 and $45 billion in 2026 alone and lead to reduced reimbursements to providers.
Temporary 2.5% payment increase under the Medicare physician fee schedule (PFS) through January 1, 2027 begins
Potential Impact — Some short-term relief from ongoing reimbursement challenges.
Medicaid expansion adults with incomes above 100% of the FPL pay up to $35 (or up to 5% of income) for most services, excluding primary care, behavioral health and services at FQHCs, RHCs, and CCBHCs
Potential Impact — While FQHCs, RHCs, and CCBHCs are exempt, REHs and rural health systems may see reduced visits or an increase in uncompensated care as people face barriers to pay for their care.
SDPs paid at higher rates (grandfathered payments) reduce 10% annually until new caps reached
Potential Impact — Reduced money for Medicaid expansion states to fund their share of Medicaid payments.
Applicable provider tax rates for expansion states reduce from 6% by 0.5% a year until no higher than 3.5% in fiscal year 2032
Potential Impact — Expansion states may have to cut services, reduce provider reimbursements, raise taxes in other areas, and/or find innovative solutions to fund their portion of Medicaid.
Individuals denied Medicaid due to work reporting requirements will not qualify for ACA premium tax credits
Potential Impact — Reduced visits or an increase in uncompensated care as people lose access to coverage.
Retroactive coverage for new applications for Medicaid reduced from 3 to 1 month for expansion adults and 2 months for others
Potential Impact — Reduced visits or an increase in uncompensated care as people lose access to coverage.
Adults 19 to 64 must work, do community service, or receive education for 80 hours a month to be eligible for Medicaid. States with approved Section 1115 waivers may start earlier. One-time compliance exemptions may also let some states delay until December 31, 2028
Potential Impact — Reduced visits or an increase in uncompensated care as people lose access to coverage.