Impact of the One Big Beautiful Bill Act on Medicaid Support for In-Home and Nursing Home Care

The Big, Beautiful Bill was signed into law on the Fourth of July. The bill’s “beauty” is open to debate, but it is clearly big, both in size (over 800 pages) and scope. In this article I will focus on how the new law’s Medicaid cuts may affect in-home and nursing home care. While it is still too early to know the precise impact on specific MassHealth-based assistance programs in Massachusetts, we can make some general projections.
 
Reduced Funding for Medicaid (MassHealth)
The One Big Beautiful Bill Act is expected to reduce federal Medicaid spending by nearly $800 billion over 10 years. For most nursing home residents in the United States, Medicaid is the primary source of funds. It also provides essential funding for a variety of in-home care options.
 
Limits to State-Directed Payments
The Act limits state-directed payments to nursing homes, which could reduce revenue for these facilities. Some nursing homes may be forced to close or cut back on staff and services, making it more difficult for elders and disabled persons to find adequate care. For a host of reasons, nursing homes in Massachusetts are already in trouble and closing. The further loss of Medicaid dollars will make it worse.
 
Greater Burden on States and Families
The Act shifts more costs associated with in-home and nursing home care to states, which may be forced to cut eligibility or benefits. Ultimately, this would increase the cost (financial and otherwise) of long-term care for elders, disabled persons, and their families, who are already under strain.
 
Optics
Overall, the Act’s provisions could limit access to healthcare services, especially for elders and disabled persons in need of Medicaid assistance to cover the high cost of long-term care. But, the Act is designed so that many of the provisions don’t take effect until after the midterms. You may not feel the loss of care options immediately, but know they are coming.
 
Your Next Steps
We don’t know what the future brings. This journey might continue, or it could change course after the midterms. Every elder and disabled person needs a flexible plan in place. In our office we often talk about Plan A, Plan B, and positioning you to be ready whether life takes you in one direction or another. You need to design a care plan that will flow with the changing political and funding winds.
 
Proper planning is essential for elders and disabled persons to obtain the care they need… preferably in their own homes but also in a nursing home if that becomes the only option. As always, I am here to help any and every way I can.
 
Until next time, take care.