What’s Happening?
No Immediate Changes for Medicaid:
If you are a Medicaid beneficiary, nothing changes right now. If you need care, continue using Medicaid. The new rules do not take effect until 2027 or later.
2027: Major Eligibility and Coverage Shifts in Medicaid
- Retroactive Eligibility Limited
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- Coverage before application:
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- Reduced from 3 to 2 months for traditional (including disability) and from 3 to 1 month for expansion Medicaid.
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- Impact: People with disabilities may have less time to enroll and cover past medical bills, increasing the risk of unpaid medical debt if enrollment is delayed.
- More Frequent Eligibility Checks
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- Increased from once a year to every six months for expansion and targeted adult Medicaid.
- Impact: People with disabilities may face more frequent paperwork and risk of losing coverage due to administrative errors or missed deadlines.
- Work/Service Requirement for Expansion Applicants
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- Able-bodied expansion applicants (not caregivers for a child under 14 or a person with a disability) must show at least 80 hours of work, school, or community service in at least one of the three months before applying.
- Impact: While this does not apply to people with disabilities, around 60% of expansion enrollees may have to prove they have a disability.
2028: New Costs and Asset Limits for Medicaid
- October 1, 2028: Copays Can Increase
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- Copays for expansion enrollees between 100–138% of the federal poverty limit may increase from $4 to $35.
- Providers can deny services if the client cannot pay.
- Impact: People with disabilities in this income group may struggle to afford needed care, including home and community-based services, risking gaps in treatment or supports if they are unable to pay.
- Home Equity Cap for Long-Term Services
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- Medicaid enrollees needing long-term services or supports cannot own a home worth more than $1 million.
- Impact: Some people with disabilities could be forced to sell their home, rent an apartment, or move to an institution.
- Reduction in Provider Taxes and Directed Payments Reduced to Medicare’s Rate
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- Current provider tax limit is 6%. Gradual reduction to 3.5% (except for nursing homes and intermediate care facilities) begins.
- Impact: Could result in fewer resources for Medicaid programs, possibly leading to service cuts or lower provider rates, which may limit access to care for people with disabilities.
Other Notable Change for Medicaid/Medicare
- Delayed Drug Coverage for Low-Income Medicare Beneficiaries
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- Delayed implementation of updated Medicaid eligibility rules may make it harder for low-income Medicare beneficiaries to get Medicaid-subsidized drug coverage.
- Impact: People with disabilities who are dual-eligible may face higher out-of-pocket drug costs or barriers to medication access.
What This Means for People with Disabilities
- No Immediate Loss of Coverage
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- Changes do not take effect until 2027 or later. No one should lose coverage right away.
- Advocacy and Ongoing Updates
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- The DLC and other advocates are talking to policymakers at the state and federal level about your needs.
- We will try to shape state and federal rules so you are protected as much as possible.
- We will tell you what we learn and how you can help.
SNAP Changes
Nationally, the One Big Beautiful Bill cuts $186 billion from the Supplemental Nutrition Assistance Program over a decade. Utah has one of the lowest SNAP participation rates in the country. Utahns with disabilities are also under-enrolled compared to the national average. Using the most recent available data, there were about 30,400 SNAP enrollees who had a disability or were older in 2022. This would be almost 17% of total program enrollment in March 2025.
The bill makes enrollment even harder by expanding the work requirement to adults up to 65 years old, veterans, and former foster care youth (individuals with a documented disability are exempt) and excluding the cost of an Internet connection from the Standard Utility Allowance. It also increases the amount the state has to pay to run the program from 50-75% in October 2026. Additionally, if Utah’s error rate (the percentage of cases in which eligibility or benefit amount is found to be incorrect) is above 6%, the state may have to pay for part of the program itself. Interestingly, states are not penalized for incorrectly denying benefits or paying too little. Even if Utah’s error rate remains low, none of this is cheap. Legislators will likely have to make some tough choices in the near future. Right now, estimates suggest a typical Utah SNAP family could lose an average of $83 a month in benefits.