Requires states to condition Medicaid eligibility for individuals ages 19-64 applying for coverage or enrolled through the ACA expansion group (or a waiver) on working or participating in qualifying activities for at least 80 hours per month.
Effective June 2025, federal regulations no longer require Medicaid applicants to apply for other benefits (including retirement and disability benefits) in order to be eligible for Medicaid.
Introduced in House (02/04/2025) This bill authorizes states to approve their own experimental, pilot, or demonstration project under Medicaid if the project provides certain benefits involving electronic benefits transfer (EBT) cards.
Major Medicare changes for 2025 center on Part D prescription drug coverage, including a $2,000 annual out-of-pocket (OOP) spending cap, eliminating the coverage gap ("donut hole"), introducing monthly payment options for drug costs, and changes to D-SNP plan rules, all driven by the Inflation Reduction Act (IRA) to lower costs for beneficiaries.
Medicaid is facing significant changes due to the 2025 budget reconciliation bill (H.R. 1/OBBBA), introducing federal work/community engagement requirements for some enrollees, potential funding cuts, restrictions for certain immigrants, and increased out-of-pocket costs for some expansion adults, leading states to already cut spending and providers to leave, risking access issues for millions, especially people with disabilities, older adults in long-term care, and low-income families.
The COLA was 2.5 percent in 2025. Nearly 71 million Social Security beneficiaries will see a 2.8 percent COLA beginning in January 2026. Increased payments to nearly 7.5 million people receiving SSI will begin on December 31, 2025. (Note: Some people receive both Social Security benefits and SSI).
77,050,295 people were enrolled in Medicaid and CHIP in the 50 states and the District of Columbia that reported enrollment data for September 2025. 69,797,328 people were enrolled in Medicaid. 7,252,967 people were enrolled in CHIP.
No, the original Build Back Better Act (BBBA) did not pass into law as a single bill; the House passed it in late 2021, but it stalled in the Senate due to lack of support from key Democratic senators like Joe Manchin, who opposed its size and scope, leading to its eventual demise as originally conceived. However, some of its key climate and social provisions were later passed as part of the separate Inflation Reduction Act (IRA) in 2022, which President Biden signed into law.
In 2025, the out-of-pocket limit for Medicare Advantage plans may not exceed $9,350 for in-network services and $14,000 for in-network and out-of-network services combined. These out-of-pocket limits apply to Part A and B services only, and do not apply to Part D spending.
The extra $144 added to Social Security usually comes from the Medicare Part B Giveback benefit, offered by some Medicare Advantage (Part C) plans, which pays back some or all your Part B premium, showing up as extra money in your check if it's deducted from your Social Security. To qualify, you need Original Medicare (Parts A & B), pay your own Part B premium, live in a plan's service area, and enroll in a specific Medicare Advantage plan that offers this "rebate," with the amount varying by plan and location.
One provision in the law will take Medicaid coverage away from people, mostly seniors and those with disabilities, who also have Medicare due to provisions that make it harder to get and stay enrolled in Medicaid.
Beginning January 1, 2027, OBBBA requires adults covered under the Medicaid expansion population to participate in mandatory work activities or show they are exempt.
The Centers for Medicare & Medicaid Services (CMS) has set the standard monthly Part B premium at $202.90 in 2026, an increase of $17.90, or just under 10 percent, from the 2025 premium of $185.00.