October 8, 2026 – As major provisions of H.R. 1, also known as the “One Big Beautiful Bill Act,” take effect, changes to Medicaid and other federal health coverage programs could impact how patients get and maintain coverage and access care. The American Medical Association (AMA) is offering resources to help patients, physicians, and medical students understand what is changing and providing guidance on how to navigate the new requirements, as part of an effort to help patients maintain access.

The law amends many longstanding healthcare policies, including Medicaid eligibility and work requirements as well as health coverage for certain immigrants. The AMA’s online resources explain what is changing, when these provisions take effect, and what patients, physicians and students need to know to protect access to care.

“When Congress was debating this bill, the AMA raised concerns that it would make it harder for patients to access care and could lead to worse health outcomes. Now that these policies are taking effect, our focus is on helping patients understand what is changing and what they can do to maintain coverage. We hope these resources help patients and physicians navigate the transition, and we are ready to work with Congress and the administration to protect patients’ access to care,” said AMA President Willie Underwood III, MD, MSc, MPH.

With major provisions taking effect this month and others beginning on January 1, 2027, patients and physicians will need to understand how the most significant changes may impact coverage and access to care.

HealthCare for Noncitizens

New eligibility restrictions for noncitizens under H.R.1 took effect Oct. 1. Eligibility rules are changing across three federal health coverage programs: Medicaid and the Children’s Health Insurance Program (CHIP), Medicare, and the Health Insurance Marketplace. The AMA’s guide to health coverage changes for noncitizens explains who is affected, what is changing, and when and how patients can take steps to maintain their coverage and access to care. There are also tips for navigating eligibility changes and what to do if one believes their coverage ended by mistake.

New Medicaid Work Requirements

Beginning Jan. 1, 2027, new federal Medicaid work and community engagement requirements will begin taking effect.

The AMA guide helps patients understand the new requirements and navigate the state and federal rules governing exemptions and compliance. Patients should talk with their physicians and state Medicaid program workers to determine whether a medical condition may qualify them for an exemption. Depending on state implementation and federal rules, certain patients — including some with substance use disorders, disabling mental illness or complex medical conditions — may qualify for an exemption.

The AMA also has been active in the courts over how the policy is being implemented. On Sept. 10, the AMA, Massachusetts Medical Society and nine national medical specialty societies filed an amicus brief for the District Court for the District of Massachusetts supporting 25 states in their motion for summary judgment challenging key provisions of the CMS interim final rule implementing new Medicaid work requirements.

On July 21, the AMA filed another amicus brief supporting 26 plaintiff states challenging a CMS interim final rule that significantly narrows the definition of “medical frailty” for purposes of Medicaid work requirements.

The AMA also has written Trump administration officials to express concerns about the work requirements and CMS guidance on a new requirement for states to redetermine the eligibility of certain Medicaid beneficiaries more frequently — every six months rather than annually.

About the AMA
The American Medical Association is the physicians’ powerful ally in patient care. As the only medical association that convenes 190+ state and specialty medical societies and other critical stakeholders, the AMA represents physicians with a unified voice to all key players in health care.  The AMA leverages its strength by removing the obstacles that interfere with patient care, leading the charge to prevent chronic disease and confront public health crises and, driving the future of medicine to tackle the biggest challenges in health care.