Prepare now for changes coming to Medicaid next year

Federal changes coming next year will make it harder for some people to get and keep Medicaid health insurance.

You may know Medicaid as Medical Assistance, which is what it’s often called in Minnesota.

To protect your health and the health of your family and community, visit the Minnesota Department of Human Services’ federal changes website to learn the facts. And don’t wait for a medical emergency – connect with a navigator to find out if you qualify for Medical Assistance, and sign up today.

Here’s what you need to know about the changes coming in 2026 and 2027.

Eligibility changes affecting some immigrants

Starting on Oct. 1, 2026, some immigrants will no longer qualify for Medicaid because of the federal changes. Immigrants who will no longer be able to get Medicaid include:

• Refugees
• People with humanitarian parole
• People who have been granted asylum
• Some abused spouses and children
• Victims of human trafficking
• Others with humanitarian protection

Medicaid will still be available to some lawful permanent residents, as well as people from Cuba and Haiti and migrants under the Compact of Free Association (COFA).

Families may experience higher medical bills when these changes take effect.

Shorter periods of retroactive coverage

For the past 53 years – since 1972 – Medicaid has provided retroactive coverage going back up to three months from when you apply. If you end up in the hospital or have a health crisis, you’ve still got time to complete the paperwork and get insured. Having insurance helps you avoid medical debt.

But starting in January 2027, it will become harder to get Medicaid to pay bills for care you received before you apply. That’s because the federal government will shorten the periods for this retroactive coverage – down to one month for adults without dependent children who don’t get Medicaid based on a disability, and two months for children, adults 65 and older, and everyone else.

Shorter retroactive coverage can hurt anyone who qualifies for Medicaid but isn’t signed up yet – especially people who have a medical emergency, find out they have a health condition, experience a mental health issue or get sick.

Example:

Maria, age 54, White Earth Nation member, lives in Mahnomen.

Health issue: Maria is diabetic and ends up in the hospital for diabetic ketoacidosis in December 2026. She finally feels better and applies for Medicaid in March 2027 with help from a friend.

Retroactive coverage: Before the federal changes, Medicaid would have covered Maria’s hospitalization. But since the federal changes took effect in January 2027, Medicaid won’t pay for her hospital stay. Maria is left with a $38,000 bill, which she can’t pay. It hurts her credit and her health because now she avoids follow-up visits out of fear of debt collectors.

Many more people like Maria will end up with medical bills they can’t pay. That’s why it’s so important to find out if you qualify for Medical Assistance and enroll now, before you need it.

Work reporting requirements

Starting in January 2027, over 225,000 adults in Minnesota could face new administrative reporting requirements to verify they are working, in school, in a work program or doing community service in order to qualify for Medicaid. 

In Minnesota, this will affect certain adults ages 21 to 64 who don’t have dependent children and don’t get Medicaid based on a disability. People subject to this requirement who don’t meet administrative reporting requirements or qualify for an exemption can lose their Medicaid benefits, even if they otherwise still qualify.

Exemptions include caring for a family member with a disability, receiving substance use disorder treatment, being incarcerated or within 90 days of release from incarceration, being medically frail, and other circumstances.

Most people with Medicaid already work, many of them in unstable, part-time or seasonal jobs with low pay.

Example:

Marcus, age 37, lives in St. Paul

Work: Marcus drives for a ride-share app and sometimes picks up restaurant shifts. He gets paid cash or through apps. Documenting his work hours will be tough because he doesn’t get pay stubs.

Health: Marcus has diabetes, so meeting the requirements will be crucial to keeping his Medicaid insurance coverage for insulin. If he loses Medicaid, his health will suffer, and it will be harder for him to stay employed. 

More frequent renewals

Starting in January 2027, adults ages 21 to 64 without dependent children or disabilities will also have to renew their Medicaid insurance every six months, instead of once a year. Having to renew eligibility more frequently leads to more people losing coverage if they miss important mail or don’t respond in time – even though they may still qualify for Medicaid.

What can I do now?

• Stay informed by visiting the federal changes page.
• Don’t wait. Enroll in Medical Assistance (Minnesota’s Medicaid program) now if you qualify. Contact a navigator today.
• Keep your contact information up to date so you don’t miss important time-sensitive materials.
• Renew Medical Assistance on time so you don’t lose your insurance. Look up your renewal date.
• If you’re currently enrolled and your renewal is current, there’s nothing else you need to do right now.
• Share your story about Medicaid by visiting the Faces of Medicaid page.