What the One Big Beautiful Bill Act Means for Retiree Health Care

President Trump signed into law the “One Big Beautiful Bill Act,” a bill that makes changes to federal taxes and spending, some of which could affect older Americans receiving government assistance for food and health care.

The bill includes new tax provisions, such as a $6,000 tax deduction for seniors and expanded deductions for charitable giving. It also reduces government spending on programs like Medicaid and the Supplemental Nutrition Assistance Program (SNAP), as well as the individual insurance marketplace created by the Affordable Care Act.

Those changes could affect some people with disabilities, family caregivers, retirees who are not yet old enough to qualify for Medicare, and others who shop for health insurance on their own. The bill does not directly affect Medicare or Medicare Advantage plans like what PERACare offers.

Health and food assistance programs

According to AARP, more than 11 million Americans age 50 and older rely on SNAP benefits to afford their groceries and more than 17 million older adults use Medicaid for their health care. The One Big Beautiful Bill Act will make it harder to qualify for both programs and will require more paperwork for some enrollees to continue receiving their benefits.

To qualify for Medicaid, people under the age of 65 will need to show that they’re working or taking part in other job-related activities, such as job training or volunteering, at least 80 hours a month, unless they qualify for an exception. States also will be required to verify some enrollees’ eligibility more often—at least every six months.

The bill also expands work requirements for SNAP food assistance to include more older Americans. Able-bodied adults under the age of 65 will have to work at least 20 hours a week to receive benefits for more than three months, unless they qualify for an exception.

Medicaid work requirements are expected to take effect by early 2027, but it’s less clear when the new SNAP requirements will go into effect.

The individual insurance marketplace

The One Big Beautiful Bill Act adds new requirements for enrolling in health care coverage through insurance marketplaces like Connect for Health Colorado.

The bill eliminates automatic reenrollment in marketplace health care plans, meaning participants in those plans will need to manually enroll every year or face losing their coverage. It also shortens the annual open enrollment period and allows the expiration of enhanced tax credits that made plans more affordable.

Experts say premiums for marketplace insurance plans are likely to go up as a result of the changes, and insurers in Colorado have already proposed substantial increases for next year.

Coverage options under PERACare

PERA’s health benefits program, PERACare, includes pre-Medicare and Medicare Advantage plans, as well as combination coverage for retirees who want to cover both Medicare and non-Medicare eligible family members.

PERA provides a health care subsidy to help offset PERACare health care premiums. The subsidy amount is based upon a retiree’s years of service, for a maximum $115 monthly subsidy for Medicare-eligible retirees.

While the federal tax and spending bill does not include changes to Medicare, other regulatory changes (among other factors) are expected to influence plan premiums next year. PERA staff are still finalizing plan details, but we do expect PERACare premiums to rise for 2026.

PERACare open enrollment will take place between October 20 and November 20, 2025, and we will have plan information available by October 1.

For more information, visit copera.org/peracare.