Division of Medical Assistance and Health Services

Governor Mikie Sherrill • Lt. Governor Dr. Dale G. Caldwell

Division of Medical Assistance and Health Services

Stakeholder Resources

Trump Administration changes to NJ FamilyCare/Medicaid will take effect beginning in Fall 2026. Signed into law on July 4, 2025, the “One Big Beautiful Bill Act” (OBBBA, also referred to as H.R. 1) makes several changes to NJ FamilyCare/Medicaid, including significant changes to non-citizen eligibility and new community engagement requirements, often referred to as “work requirements,” for certain adults ages 19 through 64.

This page provides information and resources for stakeholders who assist NJ FamilyCare applicants and members in understanding and navigating these changes.

Stakeholders include:

  • Health care providers (e.g., primary care, pharmacies, hospitals, Federally Qualified Health Centers, mental health/substance use disorder providers)
  • Application, enrollment, and member support partners (e.g., application and renewal assistors, Regional Health Hubs, advocates, legal services organizations, and other organizations that provide individualized enrollment or member support)
  • Community organizations (e.g., faith-based organizations, food banks, shelters, community centers, and other trusted organizations that provide community-based services to NJ FamilyCare member)
  • Community engagement/work requirement activity and verification partners (e.g., employers, schools, volunteer and community service organizations, workforce and job training programs, and other organizations that can help members demonstrate qualifying activities)

What is changing & when?

Beginning October 1, 2026:

Some non-citizen immigrants may no longer qualify for NJ FamilyCare based on their immigration status.

Learn more here about changes to non-citizens eligibility.

Beginning January 1, 2027:

Certain adults ages 19 through 64 who are enrolled in the Alternative Benefit Plan (ABP), also known as Expansion Adults, will need to meet community engagement/work requirements to qualify for or keep their NJ FamilyCare coverage. These requirements may include working, volunteering, or attending school. Most affected members will also need to renew their coverage every 6 months instead of every 12 months.

Some members may not be required to meet the community engagement requirements because of their health, family, or life circumstances. However, they may still need to renew their coverage every six months.

Learn more here about community engagement/work requirements.

Federal changes will also shorten the amount of retroactive coverage available to some NJ FamilyCare members. Beginning January 1, 2027, NJ FamilyCare can cover medical bills for Expansion Adult members for up to one month before the month they apply for coverage, instead of up to three months under current rules. For other members, including individuals under age 19 or age 65 and older, NJ FamilyCare Aged Blind Disabled members, and pregnant or postpartum individuals, retroactive coverage will be limited to two months before the month of application.

Resources for partners

General Information:

These resources provide information about changes to non-citizen eligibility and community engagement requirements, as well as updates on how the new federal law affects NJ FamilyCare members across New Jersey.

  • NJ FamilyCare Federal Changes webpage: an up-to-date webpage, translated into 9 of the top languages in the State, that gives an overview of eligibility changes and member resources. See subpages with detailed information on community engagement/work requirements here and non-citizen eligibility changes here.
  • Medical Assistance Advisory Council (MAAC) meetings: the MAAC convenes four times a year to provide updates and advise on health care services and policy for NJ FamilyCare/Medicaid members, including but not limited to H.R. 1/OBBBA updates. Recordings and materials from past meetings can be accessed here.

Stakeholder Support:

  • DMAHS Federal Changes resource account: To stay updated on H.R. 1/OBBBA-related developments affecting NJ FamilyCare/Medicaid, and to access related resources, sign up here to receive emails from the DMAHS resource account.
  • NJHCQI partnership: DMAHS has partnered with the New Jersey Health Care Quality Institute (NJHCQI) to support stakeholder engagement and implementation activities based on DMAHS’s strategic direction, policy guidance, and approved messaging.
    NJHCQI’s engagement will focus on health care providers, assistors and advocates who support members, community engagement support partners, and other community and social organizations. Activities will include conducting webinars and information sessions, producing informational resources and guidance, and collecting stakeholder questions.
  • Regional Health Hub support: New Jersey’s four Regional Health Hubs (RHH), The Camden Coalition, Trenton Health Team, Greater Newark Healthcare Coalition and The Health Coalition of Passaic County are working alongside DMAHS to support stakeholders and members through changes to non-citizen eligibility and community engagement requirements.
    RHHs use their regional networks to share DMAHS-approved resources, conduct targeted outreach and information sessions, and train community-based organizations, providers, and primary care providers to help members understand the changes. They also gather community feedback and help connect impacted members with available resources.
  • Managed Care Organization outreach: MCOs will conduct outreach to members who are impacted by the new changes to explain what is required and how to get help. MCOs also regularly outreach to members who have upcoming renewals via multiple modalities to remind them of required actions. MCOs additionally help disseminate state resources to their provider networks.

Expansion Adult Eligibility Changes Resources:

Starting January 1, 2027, three important changes affecting Expansion Adults will take effect: community engagement requirements, more frequent eligibility renewals, and shorter periods of retroactive coverage. The resources below can support stakeholders in raising awareness of the new requirements and supporting impacted members in maintaining coverage.

Additional stakeholder resources are coming soon.

In early September, NJ FamilyCare is sending a letter to all impacted Expansion Adult members explaining the community engagement requirements and directing members to resources that can help them understand the changes. The letter will be available in English and other languages. Expansion Adults who are newly identified before January 1, 2027, will receive the same letter ongoing on a monthly basis.

Receiving this letter does not mean a member is required to meet the community engagement requirements. Some members may be excluded or excepted from the requirements. The letter also does not require the member to take any action or respond.

Non-citizen / Immigrant Eligibility Changes Resources:

Starting October 1, 2026, some non-citizens enrolled in NJ FamilyCare/Medicaid may no longer qualify for coverage under new federal rules. This doesn't affect all non-citizen members, and ongoing eligibility depends on immigration status. The resources below provide guidance to help stakeholders support affected members, understand which immigration documents may be accepted to verify eligibility, and communicate information about the changes.

In July 2026, NJ FamilyCare sent a letter (accessible here in English, accessible here in other languages) to certain current non-citizen members requesting additional immigration documentation because their eligibility may be affected by the new federal rules. The letter is available in English and other languages.

NJ FamilyCare is working with HMS to collect these documents so that NJ FamilyCare can verify members’ eligibility under the new federal immigration rules.

Receiving this letter does not mean that a member is ineligible for NJ FamilyCare after October 1, 2026. It means that NJ FamilyCare needs additional information to determine whether the member remains eligible.

More information about this process is available in the Non-citizen Stakeholder Guide.