Partnership for Medicaid Urges CMS Guidance for AI/AN Medicaid Exemptions Under the One Big Beautiful Bill Act
On November 25, 2025, NCUIH joined the Partnership for Medicaid in a letter to the Centers for Medicare and Medicaid Services (CMS) Administrator Mehmet Oz sharing requests and recommendations regarding the implementation of the One Big Beautiful Bill Act (OBBBA) (H.R. 1). NCUIH worked with the Partnership to urge CMS to reiterate the exemption of American Indian and Alaska Native (AI/AN) beneficiaries from the new Medicaid requirements in its guidance to states.
Read the full letter here.
Background on OBBBA and AI/AN Medicaid Exemptions
On July 4, 2025, the President signed the 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 Supplemental Nutrition Assistance Program (SNAP). 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 SNAP work requirements.
Read more about these exemptions in NCUIH’s overview of the OBBBA resource.
About the Partnership for Medicaid
NCUIH is a member of the Partnership for Medicaid, which is a nonpartisan, nationwide coalition of organizations representing clinicians, health care providers, safety-net health plans, and counties. The goal of the coalition is to preserve and improve the Medicaid program.