Beginning in 2026, several changes from the federal “Big Ugly Bill” will go into effect that will impact people with disabilities and their families. To learn more about the reconciliation bill, read our fact sheet which lays out the key impacts and effects on the IDD and autism community.
First of all – Medicaid changes: the federal government will issue temporary rules explaining how work requirements should be applied by June 1, 2026 and most of the finalized rules will go into effect in 2027. Additionally, by the end of 2026, states must have systems ready to redetermine Medicaid eligibility every six months. These work requirements and redeterminations primarily apply to people covered by Medicaid expansion. New restrictions on Medicaid eligibility for certain immigrant groups will go into effect October 1, 2026.
Enhanced ACA premium tax credits, which were not extended in the reconciliation bill, expired on January 1, 2026. Many people who rely on Marketplace coverage may see higher monthly premiums.
There will also be changes to the Supplemental Nutrition Assistance Program (SNAP) in 2026, including an increase in state administrative cost-sharing, which reduces the federal share of administrative expenses. This will put pressure on state programs and the state budget. Other SNAP reforms, like expanded work requirements and reporting rules, will roll out in later years.
Overall, 2026 will bring higher health coverage costs for many people and new administrative demands for both Medicaid and SNAP. We know how overwhelming and upsetting these changes are for individuals, families, and advocates – and we share those concerns. We are tracking the impacts of this bill and its changes, lifting your voices, and continuing to advocate for protections and supports.
To share how these changes are affecting you and your loved ones, please fill out our Impact Tracker to help us share the real impacts of this legislation
For more information and detailed timelines, visit these resources:
