H.R.1, known as “The One Big, Beautiful Bill” (“BBB”) is a 2025 federal law that changed eligibility for Medicaid . These changes will have broad impacts on Medicaid. Among those impacted by the new rules are legal immigrants living in the US who may not be eligible for coverage under the changes made by the BBB.
How is Coverage Changing for Immigrants?
Starting on October 1, 2026, some immigrants might see a change in their health coverage due to federal funding cuts to Medicaid. These changes apply to:
- Refugees
- Asylees (someone who fled their country for safety)
- Parolees (someone allowed into the U.S. for temporary reasons)
- Survivors of domestic violence or human trafficking
The State of New York Is Protecting Its Immigrant Population Now That the Federal Government Has Declared War on Them
The New York State website has a question and answer page trying to address concerns about these changes making immigrants ineligible for Medicaid. The site explains how New York State has a health care plan that they will substitute in for any immigrants who have been kicked off medicaid.
If you belong to one of the affected immigration groups, your health plan coverage may change from Medicaid to the Essential Plan. You will not experience a change in your benefits as a result.
If you get tax credits to help pay for your insurance, the state will review your account in the fall. Any changes to your costs will start in 2027.
There will be no changes to coverage for children and pregnant people. Health coverage for children, pregnant individuals, and those who recently gave birth will not change.
https://info.nystateofhealth.ny.gov/stay-covered#immigration
So that’s great news but there are even more changes coming to the medicaid program.
Work Requirements for Medicaid Coverage
Starting on January 1, 2027, some adults ages 19–64 will have new work requirements for Medicaid coverage and may need to show that they are working, in school, in job training, or volunteering. These requirements will be reviewed when you apply or renew your coverage.
You can do these things to meet the requirements:
A) Earn income of at least $580 per month
B) Complete at least 80 hours per month of any of the following activities, or a combination of them:
- Work in a job
- Go to school at least half time
- Join a job training or work program
- Volunteer or help out in your community
C) Earn some income and complete some hours of approved activities (B above) each month
- For example, if you earn $380 per month, that equals 52 hours when using the federal minimum wage of $7.25 ($380/$7.25 = 52). To meet the 80 hours of approved activities, you would need to do 28 more hours of any of the activities in B above.
The $580 monthly amount relates to your household income. If you are married to another adult who is also affected by work requirements for Medicaid coverage, NY State of Health has your combined income, which is considered your household income. The household income will determine if you both meet the requirements.
Medicaid Renewals
Starting on January 1, 2027, some adults ages 19–64 will need to renew their Medicaid every 6 months instead of once a year.
If you apply for Medicaid before January 1, 2027, or renew before March 1, 2027, you will get 12 months of coverage if you are eligible. After that, you will renew every 6 months.
If you apply for Medicaid after January 1, 2027, or renew after March 1, 2027, you will renew every 6 months if you still qualify.
Learn more on the State of New York’s Website.