Medicaid Cuts Under Trump’s 2025 Bill: In July 2025, President Trump approved the along repealing and spending reconciliation package known as “One Big Beautiful Bill Act” (OBBBA). This bill provides for more than $1.1 trillion in healthcare-related savings over ten years, cutting Medicaid by a significant amount due to reduced eligibility, stricter reporting and work requirements, funding cuts, and provider limitations.
Medicaid Cuts Under Trump’s 2025 Bill: Timings
Immediate to Late 2025 / Early 2026
Several provisions might start at or near 2025 year-end and may gradually affect access and enrollment:
- In this case, limitations on Medicaid payments to some non-profit organizations supplying family planning services such as Planned Parenthood would be operating from October 1, 2025, at the earliest, subject to the outcome of the legal process.
- Some changes have been made to cut down on retroactive coverage (from 3 to 1 month for expansion enrollees), and administrative adjustments may also be staged from late 2025 or early 2026.
Beginning December 2026
Most of the changes in the administration that received the go-ahead signal from December 2026 onwards are:
- Doing away with the percent of 5% extra federal funds for states which had supported Medicaid extension under the American Rescue Plan.
- The new community engagement work or activity requirements for most enrollees aged 19-64 provide at least 80 hours per month.
- Eligibility redeterminations every six months for expansion adults instead of annually.
Starting 2027
Generally work requirements are due to be phased in 2027 widely, thus a vast number of people covers could be terminated if they fail to meet the conditions.
Medicaid Cuts Under Trump’s 2025 Bill: From 2028 Onwards
More fundamental and structural long-term issues will be itching from 2028 onwards:
- Mandatory imposition of cost-sharing for expansion enrollees by the states (up to $35 per service, capped at 5% of income), starting in October 2028.
- Gradual reduction of the “hold harmless” thresholds on provider taxes beginning at around 2028–2029 and continuing through 2034.
- Quarterly eligibility checks, provider termination verifications, and delays in nursing home staffing requirements are some of the activities that begin in 2028.
The provider payment and DSH cut exemptions have been deferred to 2029.
How Much Can You Earn and Still Get Medicaid in New York in 2025?
Importance for Medicaid Enrollees
It concerns enrollees in Medicaid specifying when the cutting timeline follows. The most immediate changes will start almost at the end of 2025 while the most significant interferences in work requirements, and six-month eligibility checks happening in December 2026 and 2027 will continue. The addition of cost-sharing will become another concern by 2028 when low-income households will have to bear the extra financial burden, and states will be facing strong pressure to raise programs with less money.
The 2025 Medicaid cuts go deep and leave over a ten-year period, but the process is staggered, and it is not a single moment. Some alterations like reduced retroactive coverage are almost here, while others, for example, provider tax cuts and cost-sharing, will take a long time to become fully actualized. Enrollees must stay abreast and ready for such a shift. For states, the dice is cast in favor of managing budgetary impulses while ensuring that care accessibility for the most defenseless residents is maintained.
