Policy & oversight
Medicaid Cuts Under Last Year's Federal Law Begin Taking Effect, Raising Risks for Dual-Eligible Medicare Beneficiaries
The Medicare Rights Center's October 1 review of H.R. 1's Medicaid provisions finds that the law's roughly 1 trillion dollar reduction in Medicaid spending over ten years poses particular risks for the millions of people who rely on both Medicare and Medicaid simultaneously.
By the Goodsurance editorial teamOctober 2, 2026
With portions of last year's federal budget reconciliation law now taking effect, the Medicare Rights Center published an October 1, 2026, analysis of how Medicaid cuts under H.R. 1 affect older adults and people with disabilities enrolled in both Medicare and Medicaid, a group often called dual eligibles.
The analysis notes that H.R. 1 set in motion a roughly 1 trillion dollar reduction in federal Medicaid spending over ten years. For dually eligible beneficiaries, who typically depend on Medicaid to pay Medicare Part B premiums, deductibles, and copayments they could not otherwise afford, reduced Medicaid access can translate directly into higher out-of-pocket Medicare expenses.
Medicaid cuts from last year's federal law are starting to take effect. Here is what it means for people who have both Medicare and Medicaid.
Several changes are now in effect or arriving soon. As of October 1, 2026, most lawfully present immigrants, including refugees and asylum seekers, are no longer eligible for Medicaid. Starting in 2027, retroactive Medicaid coverage will be shortened: traditional Medicaid beneficiaries will receive two months of retroactive coverage and expansion Medicaid enrollees will receive one month. H.R. 1 also blocked enforcement of rules that had streamlined Medicaid enrollment and opened the door for states to create new administrative requirements that historically have contributed to coverage losses.
The Medicare Rights Center describes the cuts as the largest in Medicaid's history and encourages affected beneficiaries to seek guidance from their State Health Insurance Assistance Program.
In plain words
A new federal law will cut about 1 trillion dollars from Medicaid over ten years. Many people who have Medicare also have Medicaid, and Medicaid helps them pay for Medicare costs they cannot afford on their own. As of October 1, 2026, most immigrants who are legally in the country can no longer get Medicaid. Starting in 2027, Medicaid will also cover fewer months going back in time. These changes could mean higher out-of-pocket costs for people who need both programs. If you think this affects you, contact your State Health Insurance Assistance Program for help.
Understand the basics first
Source: Medicare Rights Center
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