Following the passage last year of federal law HR 1, also known as the “One Big Beautiful Bill Act” (OBBBA), Medicaid will undergo some changes, some of which will take effect on October 1.

Medicaid is the public program of health insurance for low-income individuals and families who meet the eligibility requirements.

Enlace Latino NC  She developed a question-and-answer guide that includes information on North Carolina's new Medicaid laws, upcoming work and community involvement requirements, how to prepare for these changes, and resources for the state's Latino community.

What are the main changes to Medicaid?

The main change for people who are not U.S. citizens is that, according to their migratory statusThey could lose their Medicaid coverage. This change takes effect on October 1, 2026.

It should be noted that undocumented immigrants do not qualify for Medicaid except in rare cases of medical emergency.

¿Who will remain eligible for Medicaid ?

The immigration statuses that will be maintained Medicaid coverage As of October 1st, they are:

• US citizens.
• Legal permanent residents (with “green card” / LPR) — although many are still subject to the 5-year waiting period that already existed.
• Veterans and active-duty U.S. military personnel, and their spouses/children (this category remains protected).
• People from Cuba or Haiti who meet the established requirements to be considered “Cuban and Haitian entrants”
• Migrants protected by the Covenants of Free Association (COFA), who are citizens of the Federated States of Micronesia, the Marshall Islands and the Republic of Palau.
• Children and young people up to 19 years of age and pregnant people or those within 12 months after giving birth, who reside legally in the United States, but do not have permanent immigration status.

Which immigration statuses will lose coverage starting October 1st?

The immigration statuses that will lose Medicaid coverage starting October 1st are:

• Refugees.
• People who have been granted asylum.
• Survivors of domestic violence and human trafficking (e.g., T or U visa holders) who had qualified immigration status but not permanent residency. Also, some with humanitarian parole.
• Other humanitarian statuses that will no longer be eligible under the new federal law.
• Amerasian immigrants (Amerasian, admitted under the Amerasian Homecoming Act — children of U.S. military parents born in Vietnam) holders of Special Immigrant Visas (SIV) from Iraq and Afghanistan.

Related:  New Medicaid rules could leave thousands of immigrants in North Carolina without coverage

Work certification

Beginning January 1, 2027, most adults ages 19 to 64 who have or apply for health coverage through Medicaid will have to meet new requirements. These are:

• They must demonstrate that they have participated in an approved activity, such as working, studying, or volunteering, for a total of 80 hours per month to qualify for or maintain Medicaid coverage. This is known as "work and community participation." If they earn at least $580 per month, they already meet this requirement.
• Medicaid eligibility will be assessed every six months, instead of once a year.

You must meet these requirements for at least three months prior to your Medicaid renewal date. Otherwise, you could lose your coverage.

Who will have to meet the new requirements to maintain Medicaid?

The rules apply to adults aged 19 to 64 who:

• They do not have a disability.
• They are not pregnant and are not eligible for postpartum coverage (during the 12 months after a pregnancy ends).
• They are not parents, guardians, family members responsible for the care or family caregivers of a dependent minor under 14 years of age or a person with a disability.
• They do not qualify for an exception or exclusion.

Are there any groups that may qualify for an exception?

Yes, exceptions include:

• Children and young people up to 19 years old.
• People who qualify for Medicare
• People who receive Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI)
• People who were in jail or prison at some point during the last 3 months.

Do I need to provide documents to verify that I meet the new requirements?

Yes, the local Department of Social Services (DSS) may ask for proof that you are working, participating in community activities, or have earned at least $580 per month, to maintain your Medicaid coverage.

Jennifer Platts, from NC Medicaid, recommends keeping payroll insurance, school records, or volunteer records.

My immigration status has changed, do I need to update anything?

If your immigration status has changed, it is important that you contact your local Social Security Department immediately to maintain your NC Medicaid coverage.

I'm going to lose my coverage, is there anything I can do about it?

If you lose Medicaid coverage, you'll receive a letter. It explains why you lost coverage and tells you how to appeal the decision if you disagree. You typically have 60 days from the date of the letter to appeal. How to appeal a Medicaid decision.

To receive free help with a notice or bill, call the NC Medicaid Ombudsman at 1-877-201-3750. They operate independently of your local Department of Social Services.

In North Carolina, there are also other organizations that can help, for example the NC Navigators Consortium and Hispanic Federation.

List of resources to consider:

This article was prepared using information provided by experts from the North Carolina Department of Health and Human Services (NCDHHS), NC Medicaid, and the Charlotte Center for Legal Advocacy during the virtual "Cafecito," an informational space that addressed changes and new rules for NC Medicaid, on August 25, 2026.

To supplement this information, official sources from the website were also consulted. NC Medicaid.

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Can you lose your Medicaid? Questions and answers about the changes in North Carolina

by Emilia Rivadeneira, Enlace Latino NC
September 2, 2026

Enlace Latino NC September 2, 2026 Following the passage last year of federal law HR 1, also known as the "One Big Beautiful Bill Act" (OBBBA), Medicaid will undergo some changes, some of which will take effect on October 1. Medicaid is the public health insurance program for low-income individuals and families who meet the eligibility requirements. Enlace Latino NCHe developed a question-and-answer guide that includes information on North Carolina's new Medicaid laws, upcoming work requirements, and community involvement. In addition to how to prepare for these changes and the resources available to the state's Latino community. What are the main changes to Medicaid? The main change for people who are not U.S. citizens is that, depending on their immigration status , they could lose their Medicaid coverage. This change will take effect on October 1, 2026. It should be noted that undocumented immigrants do not qualify for Medicaid except in rare cases of medical emergency. Who will continue to be eligible for Medicaid ? The immigration statuses that will maintain Medicaid coverage starting October 1st are: US citizens. Legal permanent residents (with "green card" / LPR) — although many are still subject to the 5-year waiting period that already existed. Veterans and active-duty U.S. military personnel, and their spouses/children (this category remains protected). People from Cuba or Haiti who meet the established requirements to be considered “Cuban and Haitian entrants” Migrants protected by the Covenants of Free Association (COFA), who are citizens of the Federated States of Micronesia, the Marshall Islands and the Republic of Palau. Children and young people up to 19 years of age and pregnant people or those within 12 months after giving birth, who reside legally in the United States, but do not have permanent immigration status. Which immigration statuses will lose coverage starting October 1st? The immigration statuses that will lose Medicaid coverage starting October 1st are: Refugees. People who have been granted asylum. Survivors of domestic violence and human trafficking (e.g., T or U visa holders) who had qualified immigration status but not permanent residence. Also some with humanitarian parole. Other humanitarian statuses that will no longer be eligible under the new federal law. Amerasian immigrants (Amerasian, admitted under the Amerasian. Homecoming Act — children of U.S. military parents born in Vietnam) holders of Special Immigrant Visas (SIVs) from Iraq and Afghanistan. Related: New Medicaid rules could leave thousands of immigrants in North Carolina without coverage Work certification Beginning January 1, 2027, most adults aged 19 to 64 who have or apply for health coverage through Medicaid will have to meet new requirements. These are: They must demonstrate that they have participated in an approved activity, such as working, studying, or volunteering for a total of 80 hours per month, to qualify for or maintain Medicaid coverage. This is known as "workplace and community engagement". If they earn at least $580 a month, they already meet this requirement. Medicaid eligibility will be assessed every six months, instead of once a year. They must meet these requirements for at least three months prior to the Medicaid renewal date. Otherwise, you could lose coverage. Who will have to meet the new requirements to maintain Medicaid? The rules apply to adults aged 19 to 64 who: They do not have a disability. They are not pregnant and are not eligible for postpartum coverage (during the 12 months after a pregnancy ends). They are not parents, guardians, family members responsible for the care or family caregivers of a dependent minor under 14 years of age or a person with a disability. They do not qualify for an exception or exclusion. Are there any groups that may qualify for an exception? Yes, exceptions include: Children and young people up to 19 years old. People who qualify for Medicare People who receive Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) People who were in jail or prison at some point during the last 3 months. Do I need to provide documents to verify that I meet the new requirements? Yes, the local Department of Social Services (DSS) may ask for proof that you are working, participating in community activities, or have earned at least $580 per month, to maintain your Medicaid coverage. Jennifer Platts, from NC Medicaid, recommends keeping payroll insurance, school records, or volunteer records. My immigration status has changed, do I need to update anything? If your immigration status has changed, it is important that you contact your local Social Security Department immediately to maintain your NC Medicaid coverage. I'm going to lose my coverage, is there anything I can do about it? If you lose Medicaid coverage, you will receive a letter. It explains why you lost coverage and tells you how to appeal the decision if you disagree. You normally have 60 days from the date of the letter. How to appeal a Medicaid decision. To receive free help with a notice or bill, call the NC Medicaid Ombudsman at 1-877-201-3750. They work independently of their local Social Services department. In North Carolina, there are also other organizations that can help, such as the NC Navigators Consortium and the Hispanic Federation. Healthy Guide: Health resources for the Latino community in North Carolina List of resources to consider: Would you like to learn more about the new NC Medicaid laws? Go to medicaid.nc.gov Do you need help applying for NC Medicaid? Go to the website medicaid.nc.gov . You can apply online, using the ePass.nc.gov application, in person, or by phone. If you need an interpreter to help you with your application, call your local Department of Social Services (DSS) and ask the operator. Do you want to review the NC Medicaid eligibility requirements? You can access the website medicaid.nc.gov Can't find your local Social Services Department? Go to ncdhhs.gov to use the local DSS directory and find it. This article was prepared using information provided by experts from the North Carolina Department of Health and Human Services (NCDHHS), NC Medicaid, and the Charlotte Center for Legal Advocacy during the virtual "Cafecito," an informational space that addressed changes and new rules for NC Medicaid, on August 25, 2026. To supplement this information, official sources from the NC Medicaid website were also consulted. This <a target="_blank" href="https://enlacelatinonc.org/puede-perder-su-medicaid-preguntas-y-respuestas-sobre-los-cambios-en-carolina-del-norte/">article</a> first appeared on <a target="_blank" href="https://enlacelatinonc.org">Enlace Latino NCand is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License. PARSELY = { autotrack: false, onload: function() { PARSELY.beacon.trackPageView({ url: "https://enlacelatinonc.org/ may-perder-su-medicaid-preguntas-y-respuestas-sobre-los-cambios-en-carolina-del-norte/", urlref: window.location.href }); } }

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