The situation is dire. Millions of people in the United States are months away from losing their health care. On January 1, dramatic changes to Medicaid outlined in the One Big Beautiful Bill Act, or OBBA, will take effect, impacting who is eligible for Medicaid. The new law excludes some groups completely (like most immigrants), introduces “community engagement” requirements (defined as 80 hours a month of work, volunteering, or school) for most people (apart from the elderly, children, and pregnant women), and requires renewals twice a year (as opposed to yearly). Some people have been impacted already (Nebraska implemented its changes on May 1 and began disenrolling people this month), and some will be kicked off their health care in October, when some previously qualified immigrants are made ineligible for Medicaid.

Though 92 percent of people should remain eligible for Medicaid coverage (through either a qualifying exemption or meeting the community engagement requirements), millions will still end up losing care.