The effects of HR1 — better known as the “One Big Beautiful Bill” Act — has made the care path for many fraught with uncertainty. As such, federal benefit programs and their future funding feels more unclear. Medicaid is just one of many programs targeted for systemic change and dollar reallocation by the bill’s provisions. The Congressional Budget Office (CBO) estimated that due to the bill’s passage, within the next decade taxpayers will expect to see $911 billion in Medicaid cuts. The number hinges on removing beneficiaries through revised federal criteria and other requirements.
For now, federal Medicaid eligibility is determined by age, income, and the size of a household. Medicaid coverage itself varies from state to state: In 2014 the US government expanded eligibility for adults ages 19-64 by increasing the income threshold to 138% of the federal poverty level – realistically, 138% of $15,650 caps an annual maximum income of $21,597/yr for an individual (excluding Alaskan and Hawaiian residents as of 2025), though some states abstained from the expansion. HR1 adds several new Medicaid requirements at the national level implemented as early as this year and into the start of 2027:
- The residency and social security data of an enrollee must be checked frequently.
- Participants’ eligibility verification will occur every six months instead of once per year.
- Non-legal residents such as refugees and asylum seekers who were previously granted Medicaid access will be prohibited from coverage.
- Most participants will be required to show evidence of work, education, or community service activities for at least 80 hours per month.
People with substance use disorders (SUD) who are undergoing treatment often rely on Medicaid benefits to support their recovery and maintain a routine that reduces the risk of relapse. Independent Minnesota news outlet MinnPost recently began publishing a series of reports on the importance of Medicaid funding to securing positive SUD treatment outcomes within the state, offering insights on the uncertainty felt throughout the national healthcare landscape.
In Minnesotan communities, approximately 50 percent of SUD treatment is underwritten by federal Medicaid funds, representing well over 100 thousand patients statewide. While HR1 does stipulate that people undergoing SUD treatment are exempt from some of the new requirements, anxiety persists among both patients and providers on the now grey areas of treatment that could lead to a loss of coverage. In the field, that could extend to treatment centers undergoing treatment method audits or mission audits and thus losing coverage regardless of their effectiveness. Individuals in recovery may also struggle with maintaining documentation to prove their eligibility, or may not have a stable home address to verify residency every six months.
Come June of 2026, SUD treatment may or may not be covered by Medicaid per the mixed messaging on other federal social services programs like SNAP. Some providers are considering alternative funding, reducing services, or closing entirely. The potential consequences for people with SUD can be catastrophic: As Roots Wellness Center’s founder Katy Armendariz bluntly observes: “If people lose their Medicaid, they are going to die.”
Read the complete series of articles from MinnPost at the source link below.
Source: https://www.minnpost.com/mental-health-addiction/2026/04/medicaid-substance-use-disorder-treatment/