With the new year well under way, many Americans are beginning to feel the impact of a key legislative decision made in 2025. During the summer, the National Hispanic Council on Aging, as well as many other concerned organizations and communities, were keeping a close eye on what the Trump Administration had coined as the One Big Beautiful Bill Act (OBBB). Designed to vastly reconfigure the allocation of funds, in a sweeping effort of “budget reconciliation.” The bill was of particular worry to organizations like NHCOA, due to its debilitating cuts to social safety nets like Medicare, Medicaid, and the Supplemental Nutrition Assistance Program (SNAP). These cuts would be detrimental to the public health of Americans, worsening barriers between many households and affordable healthcare. It is an impact that we are beginning to feel now, in 2026.
In an effort to consolidate important information, the National Hispanic Council on Aging offers this summary of changes for the uninformed or unaware. We encourage all of our community members to review the changes, and ensure that any family or fellow community members who rely on Medicare are made aware.
Changes to Medicare:
1. Restrictions to Enrollment for Lawfully Present Immigrants: Previously, many immigrants who were lawfully present though still not citizens, could qualify for Medicare through meeting various requirements. This included various work requirements, like working a job where you contributed to payroll taxes for a number of years, as well as residency-related requirements, like meeting a designated length of residency to qualify.
Now, if you are not a U.S. citizen, in order to qualify for Medicare, you must be a green card holder. There are special cases such as being a “Cuban or Haitian Entrant,” or a “COFA migrant,” but these are very specific cases. If an individual was receiving Medicare benefits in 2025, but was not a green-card holder or either of these special cases, they should have received notice that their coverage will end in 2027.
2. Worsened Measures of Affordability: The OBBB introduced several measures that will affect the affordability and accessibility of drugs and treatments. A nine-year ban on making improvements to Medicare Savings Programs (MSPs) has gone into effect, meaning that these programs designed to help lower-income beneficiaries pay for premiums and out-of-pocket costs, will become less accessible.
Certain medications for rare diseases have been branded as “orphan drugs” by the OBBB. Whereas these drugs’ prices were previously able to be negotiated under the 2022 Inflation Reduction Act, the OBBB has ensured Medicare will no longer be able to make these drugs more affordable for those who need them.
3. The Inflation Reduction Act, Negotiated Prices Go into Effect: In 2022, The Biden Administration passed the Inflation Reduction Act, which included giving Medicare the ability to directly negotiate prices of certain high expenditure, single source drugs without generic or biosimilar competition. In doing so, CMS selected ten drugs covered by Medicare Part D as the first cycle of these negotiations. That cycle now goes into effect in 2026. These drugs are widely used, and treat many chronic diseases that continue to be a huge issue in the United States, such as diabetes, heart disease, kidney disease, various blood cancers, and more. Some of these drugs are seeing a discount of as much as 79% of their 2023 price.
It is these cycles of negotiation that the “orphan drugs,” as described in the OBBB, have since been removed from, such that they do not have the possibility of being negotiated.
4. Increases in Deductibles and Premiums for Part A and B Beneficiaries: Those enrolled in Medicare Part A, which covers inpatient hospital, nursing facility, hospice and inpatient rehabilitation care, can expect increases in their deductibles and premiums, though only if they were paying a premium to begin with. According to CMS, 99% of Medicare beneficiaries have at least 40 quarters of Medicare-covered employment, meaning they do not pay a premium for Part A. However, those who do not have those 40 quarters, will see modest increases in rates.
Medicare Part B, which covers physician services, outpatient hospital services, home health visits, and medical equipment, and other services not covered by Part A, will see slight increases. Standard monthly premiums are increasing by $17.90, from $185 to $202.90, and the annual deductible is increasing by $26, from $257 to $283.
For a more in-depth review of these increases, see here.
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