NNews March 2026

March 2026 5 NJAMHAA’s Expert Partners Share Advice for Coping with Impending Medicaid Cuts continued frompage 1 Keep InMind: “It’s not one cliff. It’s a sequence of things happening over time.” KimWilliams Principal Health Management Associates Paul M. Duck Chief Strategy Officer OPENMINDS W illiams shared this helpful observation and details on the timeline. “Because H.R.1 includes many Medicaid eligibility, financing and administrative changes, it’s important to separate what is already in federal law fromwhat may still change through federal rulemaking and state implementation decisions,” she said. By December 31, 2025, states had to “finish theMedicaid ‘unwinding’ process, determining eligibility for individuals enrolled during the pandemic,”Williams explained. She noted that “eligible people could lose coverage due to procedural reasons, such asmissed notices or incomplete paperwork.” Beginning inmid-2026, states are expected to begin communicatingwith Medicaid beneficiaries about newwork requirements. Also starting in 2026, eligibility will need to be redetermined twice each year. On October 1, 2026, federal match changes for certainMedicaid services will go into effect, as well as new restrictions affecting coverage for certain non-citizens. Additional financing constraints will go into effect in January 2027, and federally mandated work requirements will begin for adults in the Medicaid Expansion population. Williams noted that states may pursue phased implementation or seek approval for extensions through December 2027. Also in 2027, retroactive eligibility periods will be reduced and new administrative requirements, includingmore frequent efforts to check and update addresses and death records, will be enacted. “If these processes are not managed carefully, individuals can lose their coverage even when they remain eligible,”Williams stated. “One of themost significant structural pressures,” according toWilliams, will begin October 1, 2027, when “provider tax financing constraints will be even tighter for Medicaid expansion states.” “The whole marketplace is feeling pressure, like the sky is falling. There’s also much opportunity when there’s a high degree of pressure,” Duck stated. “We’re in a new operating climate, and we need to build and replan for it.” continued on page 6