Medicaid changes

For Medicaid, the law adds new rules for some adults in the expansion group. These adults may need to take part in “work and community engagement” activities, such as working, going to school, or doing volunteer service.

Many people, including children, are exempt from these requirements, including Alaska Native or American Indian people, caregivers, pregnant women, medically frail adults, and others. Some people will need to renew their Medicaid every six months.

The law allows states to add small copayments and limits how far back Medicaid can pay for medical bills when someone enrolls. States may ask the federal government for extra time to put these rules in place if they show they are working toward compliance.

These are preliminary estimates based on information available as of February 2026 as additional information is finalized by CMS these estimates will be updated.