The One Big Beautiful Bill (OBBB) has made headlines since it was signed into effect by President Trump on July 4, 2025. There are still many uncertainties, but we hope to demystify what is known now about how this bill may impact you and your care.
First, it is important to understand that all of the changes are happening on a federal level. This means that state governments can respond to help lessen the impact on its citizens. While some changes are inevitable, Governor Hochul and representatives from New York State may provide additional funding or support.
In New York State, the Legislature is considering a return to special session to make up for the lost federal funds. This action may not be necessary this year because the Legislature has granted Governor Hochul’s budget director the authority to make changes to the state budget adopted in May without holding a special legislative session. The state budget director can make changes that would compensate for the loss of federal aid that will be effective in 2025. However, the next state budget, due by April 1, 2026, will need to compensate for significantly more federal aid cuts scheduled in the coming years. Governor Hochul has made it clear—New York State cannot fill in the gaps caused by the OBBB.
Timeline
10/1/2026
The Supplemental Nutrition Assistance Program (SNAP) costs will shift onto states.
The administrative cost related to SNAP benefits will be shared between states, which will cover 75%, and the federal government, which will cover 25% of costs. Currently, the federal and state governments each provide 50% of the SNAP costs. Additionally, the federal government currently covers 100% of the SNAP benefit cost. Beginning October 1, 2026, New York State will be required to cover 15% of the SNAP benefit cost.
What does this mean for you?
If you receive SNAP benefits, the amount you receive per month may decrease on October 1, 2026. It is unclear at this time if New York will fill in the gaps to prevent New Yorkers from losing these benefits.
1/1/2026
Premium tax credits provided through the Affordable Care Act (ACA) will begin to phase out.
What does this mean for you?
If you receive health insurance through the ACA, you may lose coverage. On a broader scale, this will lead to a greater number of uninsured Americans, which will increase health care costs for everyone. Depending on the financial stability of your local healthcare system, this may lead to layoffs and a decrease in health care jobs.
1/1/2027
Medicaid work requirements begin, and Medicaid is required to provide semi-annual reviews.
Currently, adults age 18-54 without dependents are required to work 20 hours/week while receiving Medicaid benefits. The new requirements mean that adults age 18-64 and parents with children 14 and older are required to work (job, education, training, or community service) 20 hours/week. Additionally, Medicaid was previously reviewed once a year to maintain benefits. Now, the government will require reviews every 6 months.
What does this mean for you?
If you receive Medicaid benefits and do not currently work (job, education, training, or community service) at least 20 hours/week, you may be required to maintain your benefits. Additionally, the new requirement to review Medicaid every 6 months may result in gaps in coverage or an increase in paperwork for you and your care team.
10/1/2028
Provider tax reductions begin, and individual Medicaid costs increase.
Adults earning 100% of the Federal Poverty Limit will be required to pay up to $35 per medical service. Additionally, health care facilities will begin losing some federal matching funds.
What does this mean for you?
Your healthcare costs may increase. Additionally, your local health care facility, especially in rural areas, may suffer financially. This could lead to longer wait times, fewer available appointments, or, in the worst cases, closure of offices and hospitals.
We understand that these changes are overwhelming and navigating this level of uncertainty can be challenging. Here is what you can do for the time being:
- Remember that the first changes will occur in about a year (10/1/2026). There is still time for your local and state governments to respond to protect your rights to these services.
- In the case of SNAP benefits, reach out to your Care Coordination Manager (CCM) for support accessing resources from local food pantries and free meal services.
- Keep up-to-date with the resources below: