CMS Releases Guidance to States on Implementation of the One Big Beautiful Bill Act 6-Month Medicaid Redeterminations – Includes AI/AN Exemption
The Centers for Medicare and Medicaid Services (CMS) recently released a State Medicaid Director letter (SMDL) on implementing the eligibility redeterminations in Section 71107 of the One Big Beautiful Bill Act, which is also known as the “Working Families Tax Cut Legislation.” The SMDL includes a summary of the exemptions for American Indian and Alaska Native people from the 6-month renewal requirement (see page 4). NCUIH continues to urge 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.
