Foley Attorneys Outline H.R. 1’s Sweeping Changes to Medicaid

Foley & Lardner LLP partner Anil Shankar and public affairs director Jennifer Walsh are highlighted for their recent health care webinar in the healthcare innovation article, “H.R. 1 and Medicaid: What Healthcare Providers Need to Know About Upcoming Changes.”

The article summarizes the key takeaways from their webinar held on October 15, 2025, which assessed the new federal budget law H.R.1. and its significant changes to Medicaid and other government health care programs.

Walsh highlighted Congressional Budget Office projections showing a $911 billion Medicaid reduction over 10 years and an anticipated increase of up to 10 million more uninsured Americans by 2034. “When you cut one part of the health system, it tends to have a ripple effect on the rest of it,” she said, emphasizing that the delayed cuts until 2027 will still produce rapid downstream disruptions for the program and beneficiaries.

Shankar explained that the legislation expands eligibility restrictions, particularly impacting certain immigrant categories including asylees and refugees, and also limits federal matching rates for emergency Medicaid services, especially in states with Affordable Care Act Medicaid expansion. Medicaid retroactive coverage is additionally curtailed, signaling broader access limitations for many qualifying individuals. He cautioned that states need to act quickly to revise Medicaid budget structures and policies in response to H.R. 1’s changes.

“There is every reason to get involved with your trade associations or with your legislatures or with your state Medicaid agency to figure out what their plans are and see if you can influence those to your benefit,” Shankar said, describing the Medicaid financing changes as “a double whammy for providers” as the significant increase in uninsured patients will reduce Medicaid reimbursements and limit creative financing options for providers.

“The more the federal government pulls out, the more states will have to make decisions around patients who are not covered,” Shankar added.