CMS Releases Informational Bulletin about Medicaid Provisions with Summary of Tribal Exceptions in the One Big Beautiful Bill Act
Centers for Medicare & Medicaid Services (CMS) has recently released an informational bulletin outlining updates to Medicaid and CHIP included in the One Big Beautiful Bill Act, which is also known as the “Working Families Tax Cut” legislation. The bulletin features a summary of exceptions for American Indian and Alaska Native people in the Act (see page 32). CMS notes that it is still reviewing how these provisions affect AI/AN Medicaid beneficiaries and is committed to collaborating with tribes to develop further guidance. NCUIH has advocated to CMS to continue to consult with Tribes to ensure proper implementation of exemptions for American Indian and Alaska Native people.
Additional Information
On July 4, 2025, the President signed the One Big Beautiful Bill Act (OBBBA) into law. The OBBBA is a major bill that delivers many elements of President Trump’s legislative agenda, including new requirements for access to Medicaid and SNAP. Fortunately, Indians, Urban Indians, California Indians, and individuals determined eligible as an Indian for the Indian Health Service under regulations promulgated by the Secretary are exempted from the Medicaid requirements in the OBBBA and included in exemptions for the Supplemental Nutrition Assistance Program (SNAP) work requirements.
- Resource: Overview of the One Big Beautiful Bill Act Exemptions for American Indian and Alaska Native People (November 25, 2025)