ELV · 10-Q · 2026Q2 · Full report

OBBBA Federal Changes

Elevance Health, Inc. · 2026-07-15 · Importance 65 · Surprise 60

The One Big Beautiful Bill Act (OBBBA), signed July 4, 2025, contains multiple provisions affecting Medicaid reverifications, work/community engagement requirements for ACA Medicaid expansion populations, changes to state directed payments and provider taxes (including managed care organization taxes), and modifications to HSA-eligible plan rules and telehealth safe harbors. Implementation timing varies: many commercial-plan provisions were effective January 1, 2026, while many Medicaid-related provisions become effective in 2027 and 2028, with states able to implement some Medicaid provisions as early as 2026. Elevance expects these provisions to affect Medicaid enrollment, state rate-setting and program financing and is monitoring additional federal and state guidance being issued to implement the OBBBA. The company highlights that these legislative changes could influence member acuity and utilization and thereby impact medical cost trends and pricing decisions across its Health Benefits lines of business.