What Families Should Know About the “One Big Beautiful Bill Act” and Medicaid Changes

At At Home Palmetto, we’ve long supported families through Medicaid waiver services. You’ll see by our website and experience that our expertise is deep rooted in understanding of Medicaid policy. Today, we’re sharing a clear breakdown of recent federal changes affecting Medicaid — so you and your loved ones can stay informed.

What Just Happened?

• On July 4, 2025, President Trump signed H.R. 1, known as the One Big Beautiful Bill Act (OBBBA) into law, after approval by the Senate (July 1) and House (July 3).

• This budget reconciliation package includes significant updates to Medicaid, Medicare, the ACA, SNAP, and other federal programs.

Here are the main Medicaid changes families should be aware of:

Work Requirements

New mandates: adults age 19–64 must work 80 hours/month, with exemptions for parents, seniors, and those with medical limitations.

Eligibility Checks

Frequency of Medicaid expansion eligibility review increases from yearly to every six months.

Cost Sharing & Fees

Enrollees between 100–138% of the Federal Poverty Level may now pay up to $35 per service.

Retroactive Coverage

Retroactive Medicaid coverage is reduced: one month for expansion enrollees and two months for traditional Medicaid recipients.

Provider Tax & FMAP Changes

Federal support for state participation tools like provider taxes is reduced, and emergency Medicaid FMAP is limited for specific immigrant groups.

What This Means For Your Family

1. Regular Eligibility Reviews:

If you’re currently receiving Medicaid through expansion, be prepared for biannual check-ins — and mark those dates in your calendar.

2. Budgeting for Co‑pays:

Those in the 100–138% FPL range may start paying service fees. Knowing this ahead of time can help avoid unexpected costs.

3. Planning Coverage Start Dates:

Reduced retroactive benefits mean timely submission of applications is more important than ever to ensure continuous coverage.

What At Home Palmetto Is Doing

• Our team has reviewed Medicaid notices to help families track fees and manage paperwork.

• We’re also monitoring how states interpret provider tax and retroactive coverage rules—especially as they vary.

While we don’t advise or assist with qualification (that would be a conflict of interest), we do prepare families to understand notices, deadlines, and changes that could affect care eligibility. If you need help interpreting a Medicaid notice or understanding what this means for your home care services? Email us at hello@athomepalmetto.com.