Changes Are Coming to AHCCCS

Overview

On July 4, 2025, a new federal law called H.R. 1 (also known as the "One Big Beautiful Bill Act" and the "Working Families Tax Cut Legislation") was passed by Congress. Over the coming years, this law will create multiple changes to how AHCCCS determines eligibility, how AHCCCS members maintain coverage, and how health care is paid for throughout Arizona.

The law also includes changes to many other administrative processes. The multitude of changes included within H.R. 1 are required to be implemented by different dates between 2025 and 2032.

What Arizonans Need to Know about H.R. 1

  • Most AHCCCS members will continue to be eligible for coverage, but the new federal law will create significant changes for specific groups of members.
  • Changes are phased in over multiple years, and some of the larger changes (like work requirements) begin in 2027.
  • AHCCCS wants to help eligible members stay covered and will be sharing updates to keep members informed.

H.R. 1 Implementation Timeline

H.R. 1 Timeline
A horizontal timeline chart spanning from July 2025 to October 2029.
  • July 4, 2025: Funding Published Online.
  • Oct 1, 2026: Ineligible Eligibility Review.
  • Oct 31, 2026: Reimburse First 3 Months Community Engagement.
  • Jan 1, 2027: Retroactive Coverage.
  • Oct 1, 2027: Provide Assessment Changes.
  • Jan 1, 2028: Submit Revised Payment Charges.
  • Oct 1, 2028: Cost Sharing.
  • Oct 1, 2029: Payment Reduction for Community Engagement.

Work Requirements and Six-Month Renewals

keepMyAHCCCS Logo

Starting January 1, 2027, some adults ages 19-64 on AHCCCS will renew their coverage every 6-months and have new work requirements. Please visit KeepMyAHCCCS.com for more information about Work Requirements and Six-Month Renewals.

Federal Medicaid Eligibility Changes for Certain Non-Citizens

Federal law changes took effect October 1, 2026. The changes impacted AHCCCS eligibility for some non-citizens, including refugees, people seeking asylum, and victims of human trafficking.

An Arizonan who lost coverage due to immigration status who becomes a lawful permanent resident and meets other eligibility criteria can regain AHCCCS eligibility.

Who Remains Eligible for Full AHCCCS Coverage?

Individuals who meet all other eligibility criteria and have one of the following statuses may continue to qualify for full AHCCCS coverage:

  • U.S. citizen
  • U.S. national
  • Before becoming an LPR the customer had a qualified noncitizen status other than LPR;
  • Lawful Permanent Residents (LPRs) that meet one of the following criteria:
    • Has been a qualified noncitizen for at least five years. The five-year period includes:
      • The amount of time a customer has been in their current status; and
      • Any time the customer had the status of LPR, Parolee or Battered noncitizen before adjusting to their current status.
    • Entered the U.S. before August 22, 1996, and remained in the U.S. continuously until becoming a qualified noncitizen; or
    • Has specific connections to the military.
  • Cuban/Haitian entrant
  • Compact of Free Association (COFA) migrant

Federal Emergency Services

Individuals who no longer qualify for full AHCCCS coverage may still qualify for Federal Emergency Services (FES). FES provides limited coverage for qualifying emergency medical conditions and is not the same as full AHCCCS coverage. Federal Emergency Services covers treatment of an emergency medical condition, such as labor and delivery, a heart attack or stroke, dialysis, and emergency room care for a sudden serious condition. Members moved from full coverage to FES do not need to reapply. When a person is found eligible, enrollment in FES is automatic and an FES ID card is mailed.

Coverage Decisions and Appeals

Not everyone who received a notice in the mail lost coverage. No one will lose coverage without receiving advance notice and an opportunity to respond. If AHCCCS determines that a person’s eligibility is changing, they will receive information about the decision and appeal rights.

Need Help?

For questions or to update your information:

Where to look for health care services?

Community health centers. Federally qualified health centers see patients regardless of insurance status and use a sliding fee scale based on income. Find a Community Health Center.

Free and charitable clinics also offer primary care and prescription assistance.

Immigration legal services can help eligible Arizonans pursue a green card to become a legal permanent resident and regain eligibility for AHCCCS. See National Immigration Legal Services Directory.

Refugee Medical Assistance. Recent arrivals may still qualify through the Arizona Refugee Resettlement Program at the Department of Economic Security if they arrived in the U.S. within the past year.

What to Expect from AHCCCS

  • AHCCCS is currently working on implementation plans to develop the processes, technology, communications, and systems changes required to comply with H.R. 1.
  • Notices and timely reminders will be shared with members and stakeholders to stay up to date and prepare for changes.

What Members Can Do Now

  • Members can visit KeepMyAHCCCS.com for the latest information on potential changes changes related to work requirements and six month renweals.
  • Members should also keep their contact information updated with AHCCCS on the Health-e-Arizona Plus website.
  • Members should check their mail weekly and open all mail from the Department of Economic Security or AHCCCS. It may have important information related to these changes.

What Partners and Stakeholders Can Do Now

  • Partners can visit the KeepMyAHCCCS website for resources, toolkits and training materials related to work requirements and six month renewals.
  • Assist members to ensure their contact information updated with AHCCCS on the Health-e-Arizona Plus website.
  • AHCCCS will continue to host forums and seek input from community partners to build awareness of these changes. The agency welcomes insights into creative strategies to engage with impacted Arizonans.

Information will continually be shared as the various H.R.1 requirements go into effect.