In communities across the country, patients, health care workers and community leaders are preparing for federal changes to Medicaid as part of the One Big Beautiful Bill Act (OBBBA). As state-level implementation of work requirements and subsequent Medicaid policy changes are underway, those most impacted by Medicaid policy changes are experiencing the early impact firsthand.
For Patients, Health and Stability Are at Stake
For many patients and families, Medicaid is a critical safety net, providing services that help make daily life, independence and ongoing care possible. Families are expressing concern about what disruptions could mean for their health and stability.
- “We’ve seen a lot of health care systems in our area having to close because of [funding reductions to Medicaid]; we’re seeing changes at the schools… Some of the services that he would typically qualify for… are not going to be available this year.”
— Victoria Schiano, parent of child with disabilities who receives Medicaid coverage, Pennsylvania (March 2026) - “There’s always something that he needs… So I don’t say it lightly when I say that Medicaid helps to save his life and give him the quality of life that he deserves.”
— Bernita Richardson, parent of child with complex medical needs who receives Medicaid coverage, Virginia (Feb. 2026) - “People will be forced into nursing homes or left to rely on unpaid family care.”
— Sabrina Epstein, disability advocate, California (Jan. 2026) - “There just isn’t anything for me other than Medicaid because of my complex chronic illness. So if I didn’t have it, I wouldn’t be able to get the health care I need.”
— Phoebe Durst, Medicaid beneficiary and cancer survivor, West Virginia (Jan. 2026)
For Providers, New Policy Changes Compound Existing Pressure
Health care providers and health system leaders already feel financially strained. As they look ahead, many are assessing how potential policy changes could affect staffing, services and access to care – particularly in rural and underserved areas.
- “Even before… our health system was broken, already under enormous strain… Now imagine someone pulling billions of dollars out of that already strained system… it means fewer services, fewer staff, longer waits, worse outcomes.”
— Maureen May, registered nurse, Pennsylvania (Feb. 2026) - “[Changes to Medicaid] are directly worsening short staffing in our facilities… patients wait longer, complications increase, and lives are put at risk.”
— Brian Magner, registered nurse, New York (March 2026) - “HR1 doesn’t just affect our finances, but it affects what services are going to remain locally.”
— Autumn McFann, rural nonprofit hospital system CFO, North Carolina (April 2026) - “We are here and committed to providing care, whether it be emergent or ‘well care,’ not just sick care, to our communities… But [uncompensated care is] going to put a strain on what care we can provide… We will have to make tough decisions.”
— Dr. Takeisha Davis, safety-net hospital CEO, Louisiana (April 2026) - “Losing their coverage completely is the last thing they need, as it could be the final blow that prevents them from affording essential doctor visits and preventive care and lands them in the emergency room.”
— Anthony Ashby, urban medical center president, Nebraska (Jan. 2026)
Looking Ahead: Long-Term Impact on Communities
Beyond individual patients and providers, stakeholders are also considering how Medicaid changes could affect the health and stability of broader communities. From limiting access to emergency services or long-term care to higher costs for patients and families, many note that shifts in coverage and funding could have ripple effects across entire regions.
- “It’s so important that we don’t rip the rug out from those people who are in really vulnerable moments… Any confusion about coverage or eligibility is an opportunity for people to slip through the cracks.”
— Stephanie Strong, telehealth substance use disorder treatment CEO, Oregon (Jan. 2026) - “When Medicaid funding drops — or when eligible people lose access to Medicaid — counties face an impossible choice: raise taxes, cut other services or watch treatment programs collapse… The impact is felt across our entire community.”
— Marsha Judkins, Mayor of Provo, Utah (Feb. 2026) - “If you lose this pillar of health care financing, you can lose the facilities that you depend on for health care — hospitals, medical practices, health centers.”
— Dr. John Rugge, retired family physician, New York (April 2026) - “If clinics close, if providers shut their doors, if service lines get shut down, if there are layoffs, if uncompensated care increases, all of those things have a ripple effect to everybody else that we serve.”
— Martha Santana-Chin, nonprofit health plan leader, California (Jan. 2026)
As policymakers continue to make decisions about the future of Medicaid, these perspectives offer a snapshot into the local impact of potential changes. It’s imperative that leaders prioritize solutions that maintain Medicaid’s critical role in local communities and preserve access to the services that millions of Americans rely on.