WASHINGTON, D.C. — Big changes are in store for Medicaid and Medicare, with new eligibility rules and important deadlines.
Major Medicaid provisions of H.R. 1, also known as the “One Big Beautiful Bill Act,” are taking effect. Medicare is seeing some new changes as well, especially Medicare Part D. Experts urge beneficiaries to familiarize themselves with the updates.
Starting Oct. 1, new Medicaid eligibility restrictions for some noncitizens took effect. Beginning Jan. 1, 2027, federal work requirements could put coverage at risk for millions.
“Those who will be kicked off of Medicaid will find themselves still getting sick, still needing the doctor and the health system will have to absorb that through uncompensated care,” said Dr. Willie Underwood III, president of the American Medical Association.
Under the new rules, many adults must meet work requirements or qualify for an exemption. Dr. Underwood warns complex paperwork and medical certification requirements could leave even seriously ill patients uninsured.
“The American Medical Association does not want people to lose their coverage because they don’t understand the new rules, or missed the paperwork deadlines,” he said. “We’re also asking that the states and the federal government make sure that people have access to information, their websites are up to date… we also want people to make sure that the information that Medicaid has on them is true and accurate– their addresses are up to date, their phone numbers are up to date, and that their names on the Medicaid form meets the names that’s on their ID,” Dr. Underwood added.
Meanwhile, Medicare’s annual open enrollment is underway. Beneficiaries have until Dec. 7 to review plans and make changes for 2027.
“Medicare health and drug plans can change a lot from year to year, and we’re seeing the same thing for this coming year,” said Leigh Purvis, the prescription drug policy principal at the AARP Public Policy Institute.
That means premiums, covered medications and out-of-pocket costs could change. Medicare Part D will see some of the biggest changes.
“Oftentimes you can find a drug that is less expensive, which is why it’s so important for people to take a look at their plan options for the coming year because there could be some savings there,” Purvis said. “There’s a lot of change coming for Medicare Part D, which covers those prescription drugs you pick up at the pharmacy. One is the change in the maximum deductible, which will now be $700 in 2027. And there also is an increase in the annual out-of-pocket spending limit, which will be $2,400 in 2027. Another really important thing to keep in mind is that there are going to be 15 new drugs with Medicare negotiated prices. We already have ten drugs at negotiated prices available, and they’re saving people billions of dollars,” Purvis added.
Additional information on new Medicaid changes can be found through the American Medical Association, here.
Additional Medicare resources can be found on AARP’s website, here.
