Local seniors and their advocates are preparing for major changes in Medicare, Medicaid and nutrition assistance programs that could raise costs and restrict coverage across the state.

The budget reconciliation law signed by President Donald Trump on July 4 will reduce federal support by an estimated $5 billion over the next decade while shifting new costs onto the state, according to the Maine Department of Health and Human Services.

For MaineCare, the state’s Medicaid program, the law introduces work requirements beginning in 2027 for about 90,000 adults enrolled through expansion. Those who cannot document 80 hours a month of work, education or volunteering risk losing coverage.

DHHS projects more than 31,000 could be disenrolled in the first year, not necessarily because they fail to meet requirements but due to documentation barriers.

Sarah Irish, sales director at the Senior Planning Center in Farmington, said carriers are already reshaping Medicare Advantage plans, which bundle hospital, medical and prescription coverage.

“The direct impact of the changes will depend on what plan they are on and which county they reside in,” Irish said. “These changes could be premium increases, entire plans could be terminating or leaving a county, their drug formulary could cost more or less, benefit copays could rise or fall and the ancillary benefits (dental, vision, and over the counter benefits) could also change. People should be receiving their annual notice of change from their carrier which will outline the changes to their coverage. I am sure we will be receiving lots of calls once they have been delivered to their mailboxes.”

She added that rising prescription costs and cuts to extras like dental and vision “will present real challenges for seniors who rely on affordable comprehensive coverage.”

Dianna White, owner of White’s Senior Solutions in Livermore Falls, said Medicare enrollees should expect increases in premiums, deductibles and cost shares in 2026. She noted that kinds of prescription medications covered by health insurance plans is also shifting, while providers may leave networks and some plans may terminate in certain counties, forcing people back to Original Medicare on Jan. 1.

“Medicare Advantage and prescription drug plan enrollees should read their annual notice of change carefully,” White said. “They should receive their letter by the end of the first week in October.” She also cautioned against fraud, emphasizing that neither Social Security nor Medicare will call unless an appointment has been scheduled and that unsolicited calls are likely scams.

Coverage will be harder to maintain as eligibility renewals move from annually to every six months, and retroactive coverage shrinks to one or two months, according to DHHS. About 3,000 legal immigrants, including refugees and trafficking survivors, will lose eligibility in 2026, though children and pregnant women will still be covered.

The Supplemental Nutrition Assistance Program, also known as food stamps, which serves more than 176,000 Mainers, will see average household benefits cut by about $26 a month starting this fall. The state will lose $4.8 million a year in federal funding for nutrition education, and new work rules will extend to adults ages 54 through 64 and to many parents of teenagers, to veterans and to people experiencing homelessness.

By 2028, Maine’s share of SNAP costs is projected to rise by $60 million a year because of new cost-sharing requirements and penalties tied to payment error rates.

Maine’s health insurance marketplace, CoverME.gov, is also affected. Automatic renewals for subsidized plans will end in 2028, leaving all enrollees responsible for re-verifying their income and household details under stricter timelines.

Starting in 2026, caps on repayment of excess tax credits will be lifted, exposing households to potentially large tax bills if they underestimate income.

DACA recipients and many other immigrants will lose eligibility for subsidies, and the open enrollment period will shrink to 63 days beginning in 2027.

For those struggling with Medicare costs, the Medicare Savings Program can provide help with monthly premiums and out-of-pocket expenses. Depending on income, it can also qualify people for the federal Extra Help program, which reduces prescription drug costs. Current income limits are $2,413 a month for a single person and $3,261 for a couple under the Qualified Medicare Beneficiary level, with slightly higher thresholds for those eligible as Qualified Individuals. There is no asset test.

Applications are available online through My Maine Connection, at local DHHS offices, or by calling the Consumers for Affordable Health Care HelpLine at 1-800-965-7476.

The state says it will continue to publish guidance and work with community organizations to prepare residents for the upcoming changes.

Meanwhile, Irish and White stressed that seniors should stay informed, watch for their annual plan notices and reach out to trusted local agents or state programs for help.