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New Medicaid rules are coming. Stay enrolled. Update your contact information today.
New Medicaid rules are coming. Stay enrolled. Update your contact information today.

Understand upcoming Medicaid policy changes affecting ACA Adults, certain immigrant populations

Date: 08/18/26

Meridian is supporting our members and their providers as federal Medicaid policy changes enacted in the One Big Beautiful Bill Act, also known as H.R. 1, begin taking effect. Knowledge of these changes will allow providers to support affected patients.

Please encourage your Meridian patients to confirm that their contact information is current with the Illinois Department of Healthcare and Family Services (HFS). Stress the importance of reading and responding promptly to time-sensitive HFS notices.

New requirements for ACA Adults beginning January 1, 2027

Beginning January 1, 2027, new federal rules will affect adults who receive Medicaid coverage through the Affordable Care Act (ACA).

To prepare for these changes, HFS will begin mailing notices on September 1, 2026, to affected enrollees in the ACA Adult Program. HFS estimates that approximately 700,000 enrollees could be affected by these policy changes.

  • Work Requirements
    Affected ACA Adults must work, go to school, engage in community service, or participate in job training to get or maintain coverage OR qualify for an exemption based on an approved circumstance or condition
  • Six-Month Redeterminations
    All ACA Adult eligible enrollees will be required to complete eligibility renewals every six months instead of annually. ACA Adults who are exempt from work requirements are not exempt from 6-month redeterminations

Learn more to help patients prepare for these changes in HFS H.R. 1 Phase 2 Toolkit (PDF) and through additional resources in the HFS Federal Resource Center.

Note for YouthCare providers: YouthCare members aged 19-21 enrolled are not subject to new Medicaid requirements. Former youth in care up to age 26 who are enrolled in the Meridian Medicaid Plan through ACA expansion are exempt from work requirements.

Immigrant eligibility changes effective October 1, 2026

Effective October 1, 2026, federal law narrows the definition of certain noncitizens who qualify for Medicaid benefits. These changes are expected to affect approximately 8,400 enrollees.

HFS began sending mailed notices to noncitizen enrollees affected by these policy changes in July. Enrollees expected to lose coverage were encouraged by HFS to schedule needed appointments and refill prescriptions before October 1.

Individuals who may lose eligibility include:

Illinois’ Health Benefits for Immigrant Seniors (HBIS) program for enrollees ages 65 and older will not change.

Don’t miss important updates

Additional implementation guidance is expected in the coming months. Providers are encouraged to monitor HFS and Meridian communications for updates and resources.