Ten Things To Know About Changes Coming To New Jersey Family Care

1. “One Big Beautiful Bill Act.”  New Jersey FamilyCare is a Medicaid funded program that provides medical insurance to low-income families.  There is no asset test but there are income rules for eligibility that depend on household size.  The “One Big Beautiful Bill Act” (“OBBBA”) signed by President Trump in July of 2025 will soon make significant changes in the rules of eligibility.
2. Centers for Medicare and Medicaid Services (CMS).  On June 1, 2026, the CMS released an interim Final Rule (FR) on Community Engagement Requirements (CER).
3. Extent of Changes.  Both the OBBBA and the CMS FR affect not only New Jersey but similar programs throughout the United States.
4. Community Engagement.  Community Engagement means that the individual will complete 80 hours per month of work, study, training, or volunteering to maintain coverage.  To be eligible, an individual must be between the ages of 19 and 64.
5. Renewal of Coverage.  Coverage must be renewed every six months rather than once per year as had been the rule under prior law.
6. Exceptions from Community Engagement under the OBBBA.  The following are exceptions to Community Engagement under the OBBBA:
   • Minors.  Children under 18 years of age.
   • ABD.  Individuals who are Aged, Blind or Disabled.
   • Parent or Caregiver.  Parent or caregiver of:
     • 14 or Under.  A child under the age of 14.
     • Disabled.  An individual who is disabled.
     • Serious Medical Conditions.  An individual with a serious health condition, a mental health condition, or substance use/addiction.
   • SNAP.  Meets SNAP work requirements.
   • Pregnant.  An individual who is pregnant.
   • Postpartum.  The exception continues for a period of one year postpartum (after a pregnancy has ended).
   • Foster.  Current or foster youth under age 26.
   • Prison.  Currently or recently in jail or prison.
7. Additional Exceptions from Community Engagement under the CMS Interim Final Rule (FR).  The following are exceptions to Community Engagement under the CMS FR:
   • Individual covered under the Medicaid expansion population or through comparable §115 waivers.
   • Veterans with a total disability rating.
   • American Indians.
   • Alaska natives.
   • Those in an educational program need not be engaged for at least 80 hours per month, but they must be enrolled in an educational program for at least half-time.
   • Receiving earned income equivalent to 80 hours at the federal minimum wage.
   • States may provide temporary exceptions for individuals facing short-term hardships, such as:
     • Medical hospitalization.
     • A presidentially-declared disaster in their county;
     • High local unemployment rates.
   • States must verify compliance at application and renewal or must give individuals 30 days to demonstrate they meet the requirement before enrolling them.
8. Interim Means Temporary.  These regulations can be changed at any time, including in the near future.
9. Immigrants.  As of October 1, 2026, certain non-citizen immigrants may continue to qualify for New Jersey FamilyCare and Medicaid.  These include:
   • Lawful permanent residents of at least 5 years (calculated from the date on green card).
   • Cuban/Haitian entrants.
   • Compact of free association immigrants.
   • Children under 19.
   • Lawfully present non-citizens who are pregnant or under age 21.
10. Definition of Education.  Under the OBBBA, education includes
    • K-12 choice programs
    • Restructured high education
    • Career-focused training

It includes qualified expenses such as tuition, fees, books, uniforms, and computer technology.