Only July 4, 2025, H.R. 1, known as the One Big Beautiful Bill Act, was signed into law. The federal law made sweeping changes to Medicaid, including new eligibility requirements, more frequent eligibility reviews, changes to retroactive coverage and immigration eligibility, and future cost-sharing requirements.

Missouri is implementing those changes through MO HealthNet. Some begin in 2026, several take effect in 2027, and others follow later, affecting eligibility, coverage reviews, and what someone needs to do to stay covered. Not every change applies to every MO HealthNet participant in the same way.

With different requirements affecting different groups on different timelines, clear information matters. This toolkit gives healthcare organizations, nonprofits, community organizations, and other trusted partners ready-to-use materials to help Missourians understand what is changing, prepare for potential coverage changes, and take action.

MO HealthNet participants can take a few important steps now:

• Keep your mailing address, phone number, and email current with Missouri’s Family Support Division.
• Open and read notices from MO HealthNet and the Family Support Division.
• Pay attention to deadlines, and respond when information is requested.
• Complete your eligibility review or renewal when required.
• Find out whether Community Engagement Requirements apply to your coverage.
• Keep documentation you may need, and ask for help when something is unclear.

Medicaid policy affects healthcare access for people and communities across Missouri. Individuals and organizations can use the Letter to a Legislator templates in this toolkit to share their experiences, explain how Medicaid changes affect their communities, and tell elected officials what they want them to know.