Published August 7, 2026 at 5:33 PM CDT

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Last year, Congress passed one of the most significant cuts to Medicaid since its creation 60 years ago. It was part of President Donald Trump’s One Big Beautiful Bill Act.

People who qualify for low-income healthcare subsidies under Medicaid expansion will need to meet new criteria for eligibility, including work requirements and a more frequent redetermination process.

Beginning in January 2027, adults seeking benefits must work or volunteer 80 hours per month, be enrolled part-time in an education program or have a medical condition preventing them from working. They must go through a process every six months to confirm they are still eligible, up from the previously required once-annual check-in.

“A lot of people don’t know it’s coming,” said Bob Theis, the CEO of Samuel U. Rodgers Health Center.

Theis said many of the Medicaid recipients served by the health center face housing instability, making it difficult to notify them of upcoming changes.

Of the more than 300,000 people who lost Medicaid coverage in Missouri from January 2025 through February 2026, 92% dropped due to a paperwork error.

Experts estimate millions of people could lose coverage.

Charlie Shields, the president and CEO of University Health, said if people lose benefits, they’ll avoid getting care for chronic health issues.

“But when they come back into the system, they come back in a much more acute state, and frankly, a more expensive state to us,” Shields said.

Medicaid accounts for millions of dollars of revenue at safety net hospitals and clinics, which serve people regardless of ability to pay. Shields anticipates University Health will see an increase in uncompensated care.

Both healthcare organizations are ready to help people through the changes and paperwork process.

“We have 22 people that this is all they're going to be doing, and we'll do a lot of outreach, trying to make sure everybody knows what's coming,” Shields said.

• Bob Theis, CEO of Samuel U. Rodgers Health Center
• Charlie Shields, president and CEO of University Health