Medicaid is a critical health program for low-income survivors of domestic violence, allowing them to access physical or mental healthcare for themselves and their children following an abusive relationship. It also provides economic security for a survivor by allowing them to leave an abusive relationship and maintain their healthcare.
While we do not know exactly how many survivors are on Medicaid, we do know that Medicaid is a lifeline for many survivors as they seek safety.
Consider:
- Approximately 1 in 5 women use Medicaid for primary, preventive, and specialty care, and it covers more than 40 percent of all births
- Medicaid covers nearly half of all children, including half of those with special needs
- The majority of long-term nursing home care is paid for by Medicaid, covering more than 7 million adults age 65 and older
About the Survivors Health Access Project
In July 2025, Congress passed HR 1, also known as the One Big Beautiful Bill Act, which instituted dramatic changes to the Medicaid program. While the legislation did not specifically target survivors of domestic and sexual violence, we know that many survivors will be impacted.
Futures Without Violence launched its Survivors Health Access Project following the passage of HR 1, to help victims and survivors of domestic violence and sexual assault get and keep their health insurance in the face of the significant funding cuts, eligibility changes, and paperwork requirements included in the legislation.
Some of the most dramatic changes created by the legislation were to impose work and community engagement requirements on people receiving Medicaid, do away with many of the tax credits that helped people pay for health insurance and prohibit many immigrants from receiving Medicaid or tax credits for health care.
FUTURES is educating advocates, policymakers, and survivors about the legislation, how it impacts survivors, and how they can assist survivors in maintaining access to health care for themselves and their children.
What We’re Doing
FUTURES has held multiple online briefings since launching the Survivors Health Access Project, reaching hundreds of advocates and survivors to inform them about the coming changes to Medicaid.
In addition, we have created multiple policy briefs and fact sheets as well as several slide decks and online presentations and will continue to update these materials as new information becomes available.
We will also be creating special resources for California.
Connect with Us
To learn more, email the FUTURES’ policy team at policyadvocacy@futureswithoutviolence.org.
Work and Community Engagement Activities Under H.R. 1
Learn which work, volunteer, and education activities count toward Medicaid requirements under H.R. 1 and how survivors can maintain healthcare coverage.
Working with State Medicaid Agencies to Protect Survivors’ Healthcare
A guide for domestic violence and sexual assault programs on working with state Medicaid agencies to protect survivors’ healthcare access as new work and community engagement requirements take effect in 2027.
Medicaid Work and Community Engagement Compliance Checklist
Use this Medicaid work requirements checklist to help domestic violence and sexual assault survivors identify potential exemptions and maintain health coverage.
