Charlotte Observer: NC budget targets legal fund that could strip low-income residents of attorney help

Note: This article by Nick Sullivan ran in the Charlotte Observer on 07.02.26:

Tens of thousands of low-income North Carolinians could lose access to legal services under a provision in the state budget bill released on Tuesday, attorneys and aid providers warn.

Republican lawmakers took aim at a charitable state fund they’ve accused of financing legal aid groups with political agendas. The N.C. State Bar and The N.C. Supreme Court created the Interest on Lawyers’ Trust Accounts, or NC IOLTA, more than 40 years ago to cover civil legal expenses for people who otherwise couldn’t afford them. The State Bar administers the program.

This is the first time the legislature has tried to regulate the IOLTA process. The proposed budget would dramatically restrict eligibility in the near term and redirect the money to other uses in the long term.

The IOLTA does not use tax money. All attorneys are required by the State Bar to place client funds into a pooled bank account if the funds are too small or held too briefly to earn net interest. The collective interest is routed to the IOLTA, and a board disburses money as grants to eligible legal aid groups that apply.

The money supports cases such as consumer protections, domestic violence and wrongful evictions.

“You’re talking about women and children and even men who have been abused, and we’re seeking protective orders for them. Or people who need basic safety and shelter. Or people who are homeless. Or veterans who have served our country and are entitled to services,” said Larissa Mañon, CEO of the Charlotte Center for Legal Advocacy. “These are the cases that we’re working on. So we’re talking about people’s super basic needs.”

The budget earmarks most grant money for a new purpose and caps how much NC IOLTA can dole out each year based on when the funds were collected.

Fifteen million dollars from newly collected money would go toward an office that provides representation for indigent criminal cases. The state is already required to fund this office through taxes.

Another $2 million would go toward other programs “designed to improve the administration of justice,” a broad category that could include civil legal aid groups, although the legislature’s proposal does not explicitly state those groups are eligible.

Notably, the annual $2 million must come from unexpended money the program collected prior to July 2025. That means civil legal aid groups would rely on a finite source of pre-existing, non-replenishing funds that will eventually run out.

And even that money has new strings attached.

Mañon’s Charlotte-based organization is one of the state’s largest IOLTA recipients and works with clients including human trafficking survivors and unaccompanied children.

That work would disqualify the center from future grants under a new budget provision excluding groups helping with “matters governed by federal immigration law.”

“That would categorically take out all civil legal aid service providers in the state. I want people to really understand what that means,” Mañon said. “I never thought I’d see a day in my life where somebody publicly and in ink say, ‘I don’t want to support survivors of human trafficking.’ … For some people, immigration is just immigration.”

Organizations are also ineligible if they engage in advocacy work or encourage the public to contact elected officials in support or opposition to proposed legislation. And groups that assist in matters related to “gender transition procedures, or the provision of puberty-blocking drugs or cross-sex hormones to a minor” are also excluded.

Every state has an IOLTA program, but North Carolina would become the only one in the nation using the program to pay for constitutionally mandated criminal defense attorneys rather than civil legal aid, according to the State Bar.

Senate leader Phil Berger and House Speaker Destin Hall’s offices did not respond to The Charlotte Observer’s requests for comment.

Why is the General Assembly trying to change IOLTA?

IOLTA already took a hit last summer when lawmakers froze the fund for a full year, until the end of June 2026. Agencies shrank as a result.

NC IOLTA data shows grantees had an average of 22% fewer cases closed and 11% fewer people served during the first quarter of this year compared to 2025, said Mary Irvine, who leads the NC IOLTA.

“There were layoffs that took place starting as early as the fall of last year, which really have changed the ability of the programs to provide services,” Irvine said. “You can’t serve the same number of people when you have a smaller staff.”

During an October hearing with the House Select Committee on Oversight and Reform, Rep. Harry Warren of Salisbury — who co-chairs the committee — accused NC IOLTA of supporting “leftist” groups that lobby for partisan issues.

Amica Center for Immigrant Rights was among the recipients Warren expressed concern about, The News & Observer previously reported. The organization has received $55,000 in IOLTA funds to provide legal services in North Carolina. At the hearing, Warren flashed a slide on the screen with a quote from the Washington D.C.-based group.

“The United States’ wealth and power is built upon stolen land from enslaved labor and under the racist lie that white people were superior to Black people, indigenous people, and people of color,” the quote said.

Warren said the freeze would allow time to investigate how IOLTA grants are awarded.

The state completed an audit in April that found the program fully complied with requirements and hadn’t improperly disbursed money, though it needed to do more to monitor how funds were spent after disbursement.

Sen. Woodson Bradley, a Mecklenburg County Democrat lobbying against the changes, told the Observer she doesn’t understand why her colleagues are still targeting the program.

“What is the problem? A problem was looked for and wasn’t found by the auditor, so now what is the intention here?” Bradley said. “This is not symbolic or abstract. We’re talking about whether or not Mecklenburg residents will remain housed, stay safe, have benefits, keep families intact, navigate the legal system.”

More than one in three Mecklenburg County households are facing financial hardship and struggling to meet basic needs, according to a new report from research group United for ALICE. And 71% of low-income people in Mecklenburg County experienced a significant civil legal problem last year, according to The Charlotte Center for Legal Advocacy. Those are the people who legal aid groups are trying to reach.

Read more at: https://www.charlotteobserver.com/news/politics-government/article316315140.html#storylink=cpy

Join us for a FREE Tax Problem-Solving Event Focused on Covid-Era Tax Deadlines and Potential Refunds on June 30

Based on the rationale of a recent court decision, you may be eligible for relief from interest and certain penalties accrued from January 20, 2020 – July 10, 2023.

Charlotte Center for Legal Advocacy and K. Tyson Law are hosting a free community event to help you understand your options.

Tuesday, June 30, 2026
2:00 – 6:00 p.m.

Charlotte Center for Legal Advocacy
5535 Albemarle Road
Charlotte, NC 28212

More information can be found here:

Tens of Millions of Taxpayers May Be Eligible for Significant Tax Refunds – If They Act on or before July 10 (Part I)

How to Use IRS Tax Account Transcripts to Identify Potential COVID-19 Disaster Relief Refunds (Part II)

Protect Your Potential COVID-19 Disaster Relief Refunds By Filing Formal or Protective Claims for Refund (Part III)

Beyond Penalties and Interest: How Kwong May Affect Missed Tax Refunds (Part IV)

Students Experiencing Foster Care Deserve Stability. Charlotte Should Protect It.

Charlotte Center for Legal Advocacy’s Education Law Program: Caitlin Whalan Jones, Daniel Brown, Stephanie R. Klitsch

We believe that students experiencing foster care deserve access to the same quality education as their peers. This is an uncontroversial opinion; one you probably agree with and is even supported by federal law. Unfortunately, students experiencing foster care are far more likely to face school disruption, enrollment delays, and lost academic progress because the systems designed to support them are complex and fragmented. Moreover, many school districts across the state struggle to comply with basic federal requirements for students experiencing foster care.

Charlotte chose a different path. Many years ago, Charlotte‑Mecklenburg Schools (CMS) and Mecklenburg County Department of Social Services (DSS) created a unique and powerful model of collaboration, embodied through four CMS-DSS Educational Liaisons. So, it was a shock to learn of the proposal to eliminate these positions after June 2026, which would unravel years of progress.

The Liaisons are a small but vital team that works to ensure students experiencing foster care have access to the education they deserve and are entitled to under the law. The Liaisons actively bridge the vast gap between CMS and DSS, doing the daily work needed to keep students from falling in. Unless you know a student experiencing foster care, or were one yourself, you might have never heard of the Liaisons. But, for folks with that lived experience, the importance of the Liaisons cannot be overstated, and their loss would be deeply felt.

The educational journey for students experiencing foster care is often littered with obstacles. Frequent school changes, delays in arranging transportation, and incomplete records are just a few of the more common ones. Consequently, and through no fault of their own, these students are more likely to perform below grade-level, be retained, or drop out of school altogether. In 2025, across North Carolina, only 60% of students experiencing foster care graduated from high school within four years. Within CMS, however, the four-year graduation rate lagged at just 46%. The work of the Liaisons is to try and clear those obstacles and, hopefully, help students meaningfully access their education.

Federal law makes clear that ensuring educational stability for students experiencing foster care is not the responsibility of school districts alone, nor of child welfare agencies acting in isolation, but a shared obligation that requires close and continuous partnership. These obligations cannot be met through informal coordination. They require dedicated roles with the time, expertise, and authority to bridge systems. In Mecklenburg County, the Liaisons have fulfilled this role.

For many years, CMS and the County shared the cost of this joint work, with each entity contributing funding in recognition of their shared legal obligations and mutual interest in educational stability for students experiencing foster care. The Liaisons themselves, however, remained CMS employees throughout that time.

Understanding this history matters, because it underscores an essential point: CMS and DSS deliberately built this model as a joint solution to a joint responsibility. Their work is embedded within CMS operations, supporting more than 100 schools while coordinating with DSS, courts, health providers, and community partners.

The question before our community is not whether CMS and DSS will continue serving students in foster care. The law requires that they do. The question is whether Charlotte will continue doing so in a way that is coordinated, proven, and centered on student stability, or whether it will disperse specialized work without a clear plan and with hope the pieces reassemble themselves.

For almost three decades, CMS‑DSS Educational Liaisons have provided continuity, expertise, and accountability for students whose lives are already marked by change. Charlotte has been doing this right. We should take care not to lose ground on one of the most effective partnerships our community has built, especially when students experiencing foster care cannot afford the cost of disruption.

Charlotte Center for Legal Advocacy is a nonprofit law firm that provides civil legal services to low-income individuals and families across the Charlotte region and North Carolina. The Education Law Program (ELP) advocates on behalf of students, including students experiencing foster care, who are facing a range of obstacles to the realization of their fundamental education rights. ELP co-leads the Mecklenburg County Foster Care and Education Work Group which includes judicial, education, and child welfare stakeholders and aims to improve educational outcomes for students experiencing foster care.

We Did It! Our Building is Paid Off!

Charlotte Center for Legal Advocacy has officially paid off our building through the success of our Building Justice Capital Campaign. Even more, our supporters have helped to establish a $1 million Building Justice Endowment—strengthening our ability to serve our community for years to come.

This milestone has been years in the making. Back when our team worked in very tight quarters on Elizabeth Avenue, we began imagining something different: a dignified space where attorneys, paralegals, and clients could come together—reflecting the importance of the work happening inside.

But this campaign was always about more than a building. It marked our evolution—moving beyond being seen only as a charity supported primarily by the legal community and fully claiming our role as a critical community social justice organization for Charlotte. Along the way, we conducted feasibility studies, deepened community engagement, refreshed our brand, and expanded our fundraising capacity—so we could meet this moment with strength.

This campaign was completed with support from more than 200 donors—including 14 six‑figure donors and 41 five‑figure donors. That breadth and depth of generosity doesn’t just fund a building; it signals shared ownership of the mission that happens inside these walls.

From all of us at Charlotte Center for Legal Advocacy: we are so grateful to everyone who invested in a permanent home for justice—and for helping ensure justice will continue to live here for a very long time.

Special thanks to Building Justice Capital Campaign co-chairs Porter Durham, Alan Kronovet and Todd Stillerman, along with lead members Kenneth Schorr and Brittney Coleman. Their support built more than just a building. We consider them the architects of a more just Charlotte.

We were thrilled to celebrate all of our capital campaign supporters last week, while also unveiling the new Kenneth Schorr Suite.

Charlotte Center for Legal Advocacy Taking Over Custody Advocacy Program

Charlotte Center for Legal Advocacy (Advocacy Center) is taking over the Custody Advocacy Program (CAP) for Mecklenburg County. CAP supports children involved in high-conflict custody cases in family court, especially where there may be serious allegations such as child abuse, sexual assault, domestic violence, substance abuse, mistreatment or parental kidnapping. 

For decades, children stuck between these battles had a voice when Custody Advocate/Guardian Ad Litems were appointed through the Council for Children’s Rights (CFCR), but CFCR closed their doors last year. Without a home for CAP, Mecklenburg County District Judge J. Rex Marvel temporarily maintained a shell of the former program until a permanent home could be found. Thanks to a generous donation from the Mecklenburg Bar Foundation, the program will now be managed by the Advocacy Center to ensure that children in need will have a voice. 

The Advocacy Center will hire a staff attorney/coordinator to manage the volunteers and match/assign advocates and volunteers to cases. The need for coordinated volunteer support has become increasingly urgent, particularly as more parents navigate custody disputes without representation. 

“Far too often children in our community are stuck between high-conflict custody cases. Allegations of child abuse, parental kidnapping, substance abuse, and mistreatment emphasize the importance of accurate and reliable advocacy during custody proceedings,” said Judge J. Rex Marvel. “The Advocacy Center has decades of experience ensuring access to justice for our community. Their mission of justice and the stability of their nonprofit will ensure that children stuck in high-conflict custody proceedings will have a voice in court. This is an invaluable service to the children of our community, and one which will help countless children in need.” 

Larissa Mañón, CEO of the Advocacy Center, shared “At its core, our organization exists to pursue justice for those in need. Housing the Custody Advocacy Program within our organization is both a strategic and mission-driven decision. Children caught in high-conflict custody cases are among the most vulnerable – often navigating emotional trauma, instability, and systems that were not designed with their needs in mind. By providing custody advocacy, we ensure that their voices are heard, their best interests are prioritized, and their rights are protected during some of the most challenging moments of their lives.” 

 
About Charlotte Center for Legal Advocacy  

Since 1967, our staff and pro bono attorneys have provided comprehensive civil legal services for our region’s low-income residents. We accomplish our mission through individual advice and representation, community education and outreach, representation of groups, self-help remedies, collaboration with other agencies, community economic development, legislative and administrative advocacy, and impact litigation. Our mission is to pursue justice for those in need. Our vision is to build a just community, where all people are treated fairly and have access to legal representation to meet their basic human needs of safety, security and stability. Learn more at charlottelegaladvocacy.org

Charlotte Center for Legal Advocacy Affirms Strong Stewardship of IOLTA Funds, Supports Transparency and Continued Oversight

Charlotte, NC – In response to the recently released audit of the North Carolina State Bar’s Interest on Lawyers’ Trust Accounts (IOLTA) program, Charlotte Center for Legal Advocacy (Advocacy Center) affirms that the report found no misuse of funds by the organization and underscores the strength of its longstanding financial controls and reporting practices.

The comprehensive audit confirmed that IOLTA funds have been awarded appropriately to qualified nonprofit organizations across the state. It also offered recommendations to enhance oversight—steps that the Advocacy Center supports as part of a continued commitment to transparency and accountability.

The Advocacy Center was specifically named in the April 21, 2026 press release issued by the Office of the NC State Auditor. However, the audit report does not identify any misuse of NC IOLTA funds by our organization or make any findings specific to Charlotte Center for Legal Advocacy. Direct reference to the Advocacy Center in the report body was limited to listing it as one of the examples of organizations receiving grants from NC IOLTA in 2024.

An IOLTA account is a standard legal financial tool used nationwide. Attorneys hold client funds in these accounts temporarily, and the interest generated is directed to support civil legal aid and other public services. In North Carolina, IOLTA has distributed more than $134 million since 1983 to expand access to justice for people with low incomes—without the use of taxpayer dollars.

“IOLTA funding is a critical resource that allows us to serve individuals and families who otherwise could not afford legal help,” said Larissa Mañón, CEO of the Advocacy Center. “We are proud that this audit reflects what we already know to be true: our organization maintains rigorous reporting, compliance and audit controls to ensure every dollar is used as intended.”

The Advocacy Center receives funding from the federal government, the State of North Carolina, as well as local governments, foundations and corporations. All these funders require performance reports and financial reports for grants and contracts. The Advocacy Center is required to undergo an independent financial audit each year, which is shared with NC IOLTA as well as other funders, including the federal government.

“We welcome strong oversight and clear standards,” Mañón added. “They reinforce public trust and strengthen the impact of programs like IOLTA. Transparency is essential—not just for accountability, but for ensuring that critical legal services remain available to those who need them most.”

The Advocacy Center joins partners across the state in supporting the continued improvement and oversight of the IOLTA program, while emphasizing the importance of reinstating this vital funding for civil legal aid services.

About Charlotte Center for Legal Advocacy

Since 1967, our staff and pro bono attorneys have provided comprehensive civil legal services for our region’s low-income residents. We accomplish our mission through individual advice and representation, community education and outreach, representation of groups, self-help remedies, collaboration with other agencies, community economic development, legislative and administrative advocacy, and impact litigation. Our mission is to pursue justice for those in need. Our vision is to build a just community, where all people are treated fairly and have access to legal representation to meet their basic human needs of safety, security and stability. Learn more at charlottelegaladvocacy.org.

1957 Hospitality Group – Month of Giving

Please visit The Crunkleton, Puerta and Rosemont and order the signature cocktails during the month of March. A portion of the proceeds from the cocktail sales will benefit Charlotte Center for Legal Advocacy!

Client Testimonial

“I had a frustrating experience recently where the insurance marketplace thought I was Medicaid eligible despite that not being the case.  I made numerous calls and spent hours on the phone trying to resolve this to no avail. The process to undo this was maddening. I was referred to your agency, and luckily was assigned to Tanja Pauler. Tanja immediately scheduled a Zoom meeting with me, and worked quickly, efficiently, and pleasantly to unravel this mess, and get the incorrect Medicaid status reversed. She is super knowledgeable and knows how to maneuver the system to get things done. Without her help, I would probably still be leaving messages and emails at numerous agencies. Thank you to Tanja and to your organization.”

-Scott, N.C. Benefits Navigator Client

IOLTA Funding is Frozen: What’s at Stake?

The need for civil legal services in our community is great, and at the Advocacy Center, we work tirelessly to meet it. Each day, we witness our clients doing everything they can to overcome the barriers standing between them and stability. We see parents fighting to keep a roof over their heads and a safe home for their families, our neighbors striving to access health care, local veterans and seniors seeking the benefits they’ve earned, and individuals navigating a complex legal system who need access to an attorney to truly have access to justice. 

Recent funding losses resulting in staff reductions have already affected those who rely on our services, and now we face another challenge: a funding freeze on the Interest on Lawyers’ Trust Accounts (IOLTA).  

This year, IOLTA provided $765,000 in grants that supported our services. Since 1983, IOLTA has awarded $134 million in grants to strengthen access to justice statewide, including nearly $12 million to 35 nonprofits across North Carolina in 2025. For our clients, this funding represents access to legal services that provides stability, safety, and hope: 

  • Meet Tad: A mother wrongfully accused of fraud regained her childcare assistance and her hope thanks to the dedicated efforts of our Public Benefits Unit. 
  • Meet Renai: Facing the loss of her family home, Renai navigated complex bankruptcy proceedings with our help, securing a plan to preserve her family’s legacy with the help of our Consumer Protection Program. 
  • Meet Sarah: A single mom and hairdresser faced an unexpected $20,000 tax bill caused by her former partner. With support from our Low-Income Tax Clinic, Sarah provided the necessary records and affidavits, and we successfully proved the taxes were not hers, giving her financial stability and peace of mind. 

These stories show what’s possible when access to justice is within reach. 

How is the Advocacy Center moving forward? 

We recently added a program providing civil legal services to children when a partner organization, Council for Children’s Rights, was forced to dissolve in the face of these changes. This program is extremely important for our community, and we feel grateful to be entrusted to keep this program moving forward. 

We are working on reimagining our organization’s role in a transformed legal landscape. Through strategic planning, we will identify and prioritize new, community-based legal initiatives that respond to current needs, leverage technology, and expand access to justice. 

We are laying the groundwork for launching new, community-driven legal initiatives that respond to emerging needs in real time. Not just sustaining our organization, we want to center the survival, resilience and empowerment of our clients and community, guiding us to design innovative legal solutions rooted in their lived experiences and evolving needs. 

How You Can Help 

  • Contact Kelly Lynn to explore personalized ways to get involved and support access to justice in your community. 

Major Changes Coming to Health Coverage Access: What Consumers Need to Know

Major Changes Coming to Health Coverage Access: What Consumers Need to Know 

Charlotte Center for Legal Advocacy | October 2025 

Important changes to both Marketplace and Medicaid health coverage programs are scheduled to begin this year, significantly impacting low-income individuals, immigrant communities, and those who rely on coverage assistance programs. These reforms are the result of recent regulations from the Centers for Medicare & Medicaid Services (CMS) and the passing of the Budget Reconciliation Bill (P.L. 119-21). The changes will take effect from August 2025 through 2028. 

Key Marketplace Changes – Effective August 25, 2025 

  1. Elimination of Low-Income Special Enrollment Period (SEP) 
    Consumers earning under 150% of the Federal Poverty Level (FPL) will no longer be able to enroll year-round. This change affects nearly 47% of 2025 enrollees
  1. Marketplace Ban on DACA Recipients 
    DACA recipients newly eligible for coverage in 2025 will be barred from coverage and have their plans terminated as of September 30th, 2025. 
  1. Less Time for Data Matching 
    The additional 60-day grace period for resolving income inconsistencies is eliminated. Failure to resolve within 90 days will result in the end of subsidies. 

Marketplace Changes – Did not take effect on August 25, 2025 

Changes enacted on August 25, 2025, that have been stayed by the litigation in the court system 

  1. Self-Attestation to income above 100% FPL 

Verification required if attested income on the application differs from federal data sources 

  1. Past-due premiums 

The new rule allows insurers in all states to deny coverage for an upcoming year to individuals with unpaid premiums at any point in the past. 

  1. Extending the ‘de minimis’ amount for plans 

Changes “de minimis” amounts guiding the plan’s metal level out-of-pocket cost share. 

Would allow insurers to offer plans with actuarial values below the standard value.  

Marketplace Changes Coming in 2026 

  • Loss of Enhanced PTCs & Return of Full Repayment Rules: 
    Unless Congress acts, 2026 marks the end of enhanced subsidies and the reinstatement of full repayment requirements for overpaid tax credits. This will eliminate the marketplace premium payment threshold as well. 
  • Eliminates APTCs’ repayment caps 

Starting in tax year 2026, households with incomes higher than their projected income or those who are otherwise ineligible for the premium tax credit will have to repay all excess PTCs they received.  

  • Elimination of PTCs for Certain Immigrants: 
    Those not eligible for Medicaid due to status, and earning below 100% FPL, will now be denied Premium Tax Credits. 
  • Gender-Affirming Care Removed as Essential Benefit: 
    States will no longer be able to include gender-affirming care as an Essential Health Benefit. States must fund this care directly if they wish to continue offering it. 
  • Eliminates automatic re-enrollment in a Silver plan where available: 
    Consumers won’t be automatically moved to lower-cost plans even if one is available. 
  • Increase in plan premiums, Out-of-Pocket Maximums, and consumer cost sharing (due to changes in formula): 

MOOP for 2026 plans will increase from $10,150 to $10,600.  Net premiums (after APTC) will increase by 2.7 percent. 

Reduced PTCs based on higher expected consumer contribution % (this is on top of the end of enhanced PTCs).  

Marketplace Changes – Will not take effect on January 1, 2026 

Changes are suspended due to litigation in the court system, and we are expecting a final ruling 

  • Stricter Special Enrollment Verification: 
    Consumers will have just 30 days to submit proof of life changes like marriage, birth, or moving. 
  • $5 Passive Enrollment Fee: 
    Consumers re-enrolled passively into a $0-premium plan must pay a fee or their plan won’t activate. 
  • Re-instates one-year failure to reconcile PTCs (for plan year 2026 only) 

This means that those enrolling in the Marketplace plan for 2026 must reconcile their PTCs for both 2023 and 2024 tax years; otherwise, they will not be approved for 2026 PTCs. 

Permanent Marketplace Changes in 2027–2028 

  • Shortened Open Enrollment Period: 
    Open enrollment will now run only from Nov. 1 – Dec. 15 in most states. 
  • Immigration-Based PTC Restrictions: 
    Most lawfully present immigrants lose eligibility for subsidies, with exceptions for Legal Permanent Residents, COFA migrants, and Cuban-Haitian Entrants. 
  • Work Requirement Impact: 
    Consumers disenrolled from Medicaid for not meeting work requirements will also be ineligible for Marketplace subsidies. 
  • Higher Burdens to Maintain Coverage: 
    From 2028, auto-reenrollment and subsidy continuation will require active reapplication and complete documentation verification. 

Medicaid Program Reforms – Effective 2026 Onward 

The Medicaid program will also undergo significant structural and eligibility changes: 

Starting October 1, 2026: 

  • Narrowed Definition of “Qualified Immigrant”: 
    While the HR1 reconciliation bill does not change the definition of qualified immigrants, it ends federal Medicaid matching funds for all categories other than LPRs, USC, and COFA migrants. Does not change the rule around the state option to ensure pregnant people and minor children.  

Starting January 1, 2027: 

  • Work Requirements for Expansion Adults: 
    Adults ages 19–64 in the expansion category must report at least 80 hours/month of work or qualifying activity. 
  • Shortened Retroactive Coverage Window: 
    Retroactive eligibility was reduced to 1 month for expansion adults and 2 months for others. 
  • Eligibility Redeterminations Every 6 Months 
    Replacing the current annual review. 

Starting October 1, 2028: 

  • New Cost Sharing Requirements: 
    Expansion adults with incomes between 100–138% FPL will be subject to up to $35 per service, with some key exemptions. 

What Should Consumers Do? 

To stay covered and minimize disruptions, individuals should: 

  • Read and respond to notices from the Marketplace and Medicaid offices. 
  • Actively update income and household information. 
  • File taxes and reconcile Premium Tax Credits. 
  • Pay premiums on time or seek assistance. 

Get help from Navigators to understand changes and requirements.