HR 1 (One Big Beautiful Bill Act, 2025)
On July 4, 2025, HR 1, also known as the One Big Beautiful Bill Act (OBBBA), was signed into law. The bill included more than 21 Medicaid reforms. Most of the provisions in the bill will go into effect beginning in the fall of 2026 or later.
Utah Medicaid is currently reviewing the bill, analyzing it for impacts and estimates, and preparing for future programmatic changes. There are many details that have yet to be defined.
We anticipate that guidance from the Centers for Medicare and Medicaid Services (CMS) will be provided to states over the next several months. This guidance will give Utah further direction from the federal government on how to implement these changes.
While some members without citizenship may lose eligibility in the fall of 2026, the majority of Medicaid members should not feel an immediate impact from this bill.
Benefits will stay the same for the large majority of kids, adults with disabilities, and pregnant and postpartum women. However, the new law will make some people without citizenship ineligible for Utah Medicaid starting in the fall of 2026. Utah’s State CHIP program will continue to be an option for qualifying children through June 2028.
Learn more about losing health insurance coverage and Catastrophic Health Plans here.
OBBB Timeline