OBBBA and Medicaid
Last year I wrote in this blog about the One Big Beautiful Bill Act (OBBBA) which Congress passed and the President signed into law last year. OBBBA contains some changes to Medicaid, although they have not yet taken effect. Since the law’s passage, we have received calls from current and prospective clients speculating as to how the changes contained within OBBBA will affect New Jersey Medicaid benefits. My answer has been that no changes have yet occurred and I don’t believe any changes will affect the Medicaid programs that we work to qualify our clients for.
New Jersey has now begun to answer these questions with a July 31, 2026 letter sent to all Medicaid recipients. The first item the letter addresses is that no changes to Medicaid have occurred yet and secondly that not everyone will be affected.
The letter refers the reader to the state’s webpage for more details which can be found at “FederalMedicaidChanges.nj.gov”. As with much that the government puts out, the page is a bit confusing and doesn’t always contain certainty – although that is in part because the states are still waiting for more guidance from the federal government.
Nevertheless, what is clear confirms what I have been telling people. While there will be a requirement that some Medicaid recipients either work, volunteer or enroll in schooling to be eligible, this requirement will not apply to anyone under 18 or over 65 years of age.
The age 65 limit is relevant to our clients since most long term care Medicaid recipients are over age 65. I don’t expect that long term care Medicaid recipients who do fall within the 18 to 65 range will be affected either by the “work/volunteer/school requirement because there will be an exception for those individuals who have a health condition that prevents them from working. Medicaid recipients who have already established that they need nursing level care are not likely to be able to work, volunteer or go to school.
Other changes are focused on citizen vs. non-citizen status. Most people receiving long term care benefits are citizens and that is certainly the case with our clients. Certain non-citizens who are residing here legally are also eligible. OBBBA narrows the eligibility exceptions for non-citizens but, again, this won’t affect U.S. citizens and the details of this change haven’t been released yet by the federal government.
The take away for recipients of Medicaid’s long term care benefits who are citizens or legal residents is that OBBBA won’t impact them.