Federal Focus: Shaping the One Big Beautiful Bill Act

For the past six months, the CareSource Federal Government Relations team has worked tirelessly to shape the One Big Beautiful Bill Act.

Because of your support, our voices were heard. We educated members of Congress about the potential impacts the bill could have on states, health plan members and the broader health care system. We extended our outreach across both House and Senate offices and helped to influence the positions of our trade partners. At every step, we amplified the stories of our members, ensuring their needs remain at the heart of policy conversations.

As part of these efforts, our team successfully advocated to delay the onset of the effective dates of several key provisions in the bill that are poised to impact Medicaid and Marketplace access across the country and place additional financial and administrative burden on states.

Now, as we review the more than 900 pages of legislative language within the One Big Beautiful Bill Act, the next phase of our advocacy work begins. With time on our side, we have meaningful opportunities to influence how these policies are implemented and continue educating lawmakers on the real-life impacts these changes will have on the people and communities we serve. 

Top Priorities for Continued Advocacy

While the rulemaking process is still unfolding at both the state and federal levels, our team is actively identifying opportunities where CareSource is positioned to support state agencies and our members.

Our key focus advocacy areas include:

1. Medicaid Work Requirements
   The One Big Beautiful Bill Act introduces new federal work requirements for able-bodied adults enrolled in Medicaid expansion, with implementation slated for December 31, 2026. However, states that demonstrate good faith efforts to comply may receive an extension of up to two years.
   
   CareSource is uniquely positioned to help states meet these requirements. We’ve already successfully developed and implemented programs like JobConnect™, which connects members to employment, training and support services. We stand ready to support state agencies that need a trusted, experienced partner to help them navigate these changes with agility and confidence.
   
2. Provider Tax Restrictions
   New provisions in the One Big Beautiful Bill Act impose limitations on states’ use of provider taxes to finance Medicaid, potentially leading to reductions in services and even hospital closures, particularly in rural communities. As the rulemaking process begins, our team will continue advocating to preserve states’ ability to fund Medicaid effectively without compromising care access or quality.
   
3. Marketplace Eligibility & Enrollment Barriers
   Several provisions in the bill are expected to increase the administrative burden on individuals seeking coverage through the Marketplace. Applicants would need to verify certain information before coverage can begin, and in the case of a special enrollment period, to receive premium tax credits.
   
   Additional changes could narrow eligibility for special enrollment periods and allow the IRS to recapture excess tax credit payments without limitation.
   
   CareSource is advocating to minimize disruptions to coverage and help ensure that the Marketplace remains a viable path to affordable care. We’re committed to educating policymakers about the real-life implications of these provisions and supporting our members through any changes ahead. 

Your Support Makes a Difference

Every dollar cut from these programs affects real people — families, children, veterans and vulnerable communities who rely on Medicaid managed care.

Because you stand with our mission, we’re able to stay at the table and continue the work to advocate for thoughtful implementation, educate policymakers and protect access to high-quality, affordable care. Your support makes all the difference.