Bureaucratic changes built into the Trump administration’s One Big Beautiful Bill Act will, starting in January, make it harder for people to keep their Medicaid coverage in tact. Local nonprofits working with clients with mental health issues, housing and food insecurity are busy now to keep marginalized neighbors covered.
The Medicaid changes will place more onus on local residents to demonstrate they are meeting new requirements and will create more paperwork to process, not only for the state but organizations like Oak Park’s Thrive Counseling Center.
“We’re preparing and anticipating what’s to come,” said Jenni Rook, Thrive’s president, noting that the Affordable Care Act (ACA), a subset of Medicaid, is going to require a six-month renewal, not annual as in the past.
“It’s twice as frequent as before, which unfortunately allows an opportunity for greater loss of coverage,” added Rook’s colleague, Tyler Alvarez, Thrive’s assistant director of referrals and coordination.
“With the changes for 2027, there is a subset in the Medicaid population that is being impacted,” Alvarez said. That’s those who became eligible for Medicaid under the ACA, also known as the “ACA expansion plan.”
“For those clients there will be additional items that will be required to provide that eligibility piece,” Alvarez said.
That’s the whole point of the changes that were part of the One Big Beautiful Bill Act that became law last year, according to Lynda Schueler, CEO of Housing Forward.
“That seems to be the undergirding message from the federal government, repeal the benefits low-income people should be entitled to,” Schueler said, “then adding the extra layer of having to reapply.
“They want to kick people off by creating this additional layer of administrative burden, so there is a level of savings that comes out of this.”
Markedly more paperwork
For Jennie Hull, CEO of Oak Park’s Beyond Hunger, the changes are eerily similar to those of Supplemental Nutrition Assistance Program (SNAP) benefits through the U.S. Department of Agriculture.
As of May 1, any able-bodied adult without dependents had to start logging 80 hours of work per month, or they would lose their SNAP benefits. SNAP is a program that is designed to work with food pantries like Beyond Hunger.
Every six months, residents on SNAP must renew their benefits by reporting their working status.
“It’s the same people getting hit again,” Hull said of the Medicaid changes. “I think there are people who are still reeling from SNAP. Some people give up on these benefits programs. I can see that locally happening.”
Alvarez said that Medicaid’s ACA expansion plan has that 80-hour monthly work requirement, which could include a combination of school enrollment or volunteering. Someone with a chronic illness or a mental health impairment would hypothetically be exempt but must be able to prove that they qualify for an exemption, which would include a doctor’s diagnosis, for example.
That means more paperwork and legwork, which is a major burden for those whose health is compromised.
Or, Schueler said, are housing insecure.
“You miss a piece of mail or lose a piece of mail because you lost your housing,” she said. “You have no way of getting access to that mail. The burden and hardship this is going to cause for people who are unhoused is going to wreak havoc on our population because of having to refile and that missed first or second follow up.
“If you miss that notification or an email or what have you, you’re going to lose your benefits if you’re not submitting your paperwork in a timely way.”
Schueler said Housing Forward is taking steps right now to help mitigate that eventuality for many.
“We’re preparing our case managers,” she said. “We are updating our own case management system to be able to put reminders in for our clients so then we can anticipate when a client is up for renewal so we can help them get that filed in a timely way.”
Communications crucial
Thrive’s Rook said a major issue is people who don’t realize they have Medicaid.
“They have a plan that says Blue Cross Blue Shield and they don’t realize it’s a Blue Cross Blue Shield community plan, which is a Medicaid managed care plan,” she said. “There’s all this education that needs to happen … what insurance (do) they have, and what are they going to have to do.”
To that end, Thrive is distributing flyers in waiting rooms and lobbies, using social media and other communications levers to let people know the reality of the situation.
Rook credited Oak Park Township and its communications strategy to get the word out in the community. Mary Anne Ojeda, the township’s assistant director for senior and disability services, said it is using its website and social media accounts to that end, along with e-newsletters and printed newsletters and direct outreach to senior-centric buildings and events to help that population understand the coming changes and to pay attention to their mail.
Ojeda is also a member of the Rush Oak Park Community Engagement Council, which is working with many partners, including Thrive, to plan Medicaid redetermination events this fall.
“Any resident, really, they need to check their mail regularly,” she said. “Just make sure they have read every notification thoroughly and if they don’t understand, go to a place that you can get help, at the township or someplace else.”
Schueler said Housing Forward’s case managers can help, but she also pointed to the Cook County’s GetMedicaidFacts.com and ABEIllinois.com, the state’s website where one can apply for benefits. Beyond Hunger has dedicated a page on its website as well.
“Our population is experiencing housing insecurity and the last thing on their mind is gathering paperwork and they don’t have a mailing address,” she said.
Changes galvanizing community
Rook said that Medicaid is Thrive’s biggest source of funding, “so there is a lot of risk to Thrive if people lose their healthcare.” That’s why her organization is placing even greater emphasis on their population.
“We’re not just going to discharge them from services because they no longer have Medicaid,” she said. “We’re going to dramatically reduce the sliding-scale fees in January, the same time this rolls out, because we want to be able to continue their coverage.” That, she said, will likely involve more fundraising and philanthropy.
Ojeda said the changes are in a way galvanizing community services to help its most vulnerable.
“I would say yes, we’re working really closely together to help educate people to get the assistance they need,” she said. “It takes a village to navigate.”