How NJ's Medicaid cuts will roll out
Work rules, cost hikes and eligibility checks start in 2027
By: Hannan Adely
NorthJersey.com
USA Today Network - New Jersey
..... About 350,000 New Jersey Medicaid recipients - nearly 1 in 5 - could lose coverage under President Donald Trump's massive tax cut and spending bill, according to the state Department of Human Services.
.....
The "Big Beautiful Bill," as Trump has called it, includes a $1 trillion reduction in spending over the next decade for Medicaid, the government insurance program for low-income Americans. Trump signed the bill on July 4. [2025]
..... In New Jersey, where Medicaid is known as NJ FamilyCare, new regulations and funding cuts in the federal legislation will roll out over the next few years. The Department of Human Services explains:
...... Work requirements: All "able-bodied" adults will face a requirement to work 80 hours a month, starting as early as January 2027, and no later than January 2029. Students, caregivers or individuals with a disability could qualify for an exemption.
..... Out-of-Pocket costs: The Affordable Care Act gave states the option to expand Medicaid to eligible residents who earn up to 138% of the federal poverty level - or $12,597 for an individual. New Jersey was among 40 states that expanded Medicaid eligibility for this target group. Under the new legislation, this group of recipients will undergo eligibility redetermination every six months starting January 2027. They will also be required to pay more out of pocket toward the cost of treatment starting in October 2028.
..... Retro Coverage: The legislation limits retroactive coverage to one month before applicants for the "expansion" group and two months before for traditional enrollees, starting in January 2027.
..... Immigrants: Immigrants who are in the country illegally do not qualify to enroll in Medicaid or other health insurance programs under the Affordable Care Act, despite claims to the contrary by the Trump administration. Currently, some immigrants who are lawfully present in the country do qualify, although many - including lawful permanent residents also known as green card holders - must wait five years before they can sing up. The new bill removes Medicaid eligibility for some non-citizens, including refugees, certain abused spouses and children, and people granted asylum, Reuters reported. the new regulations take effect in October 2026.
..... The state's Department of Human Services said New Jersey will also see a $3.3 billion annual cut in funding to hospitals and public health funding and a $360 million annual cut to the state budget due to reductions in federal funding and provider assessments.
National debt
..... Nationwide, Medicaid is being cut by nearly $1 trillion. nearly 12 million people will lose coverage over the next decade, said the nonpartisan Congressional Budget Office. The Senate Joint Economic Committee Minority shared a higher estimate of 20 million.
..... The savings will not be enough to offset a reduction in tax revenues of roughly $4.5 trillion over 10 years and increased spending in other areas, including the military and immigration and border enforcement. The bill is expected to add $3.4 trillion to the national debt over a decade, the Congressional Budget Office said.
..... In New Jersey, voting over the bill split along party lines. It passed the House by a vote of 218 in favor to 214 against, with the state's three Republican representatives - Representative Tom Kean Jr of the 7th Congressional District, Representative Chris Smith of the 4th Congressional District and Representative Jeff Van Drew of the 2nd congressional District - voting for the measure. The nine Democratic members of the New Jersey delegation all voted against it.
..... This story contains material from USA Today