How could Medicaid cuts affect long-term care?

Jul 15, 2025

Rachel Werner, Executive Director of the Leonard Davis Institute of Health Economics, delves into the dramatic implications of the One Big Beautiful Bill Act, which could slash Medicaid funding by over $1 trillion. She explains how these cuts may force millions into nursing homes, diminishing care options and increasing family responsibilities for older adults. Werner also discusses the urgent need for proactive financial planning for long-term care amid these legislative changes, making it clear that the landscape of health care is about to shift dramatically.

Ask episode

AI Snips

Chapters

Transcript

Episode notes

INSIGHT

How Medicaid Cuts Reduce Funding

Medicaid funding cuts mainly come from limiting provider taxes used by states to leverage federal matching funds.
These cuts will reduce available Medicaid resources and hurt care for millions, especially older adults and those with disabilities.

INSIGHT

Cuts Threaten Care Options

Medicaid must fund nursing home care, but cuts may reduce daily rates or eligibility, lowering care availability and quality.
Home and community-based services which help people live independently are optional and likely to face deeper cuts, driving more people to nursing homes or unpaid family care.

INSIGHT

Funding Cuts Worsen Inequality

Medicaid benefits vary widely by state because of state-level program control.
Funding cuts will widen inequalities as wealthier states can offset losses, while poorer states will reduce services further.

Get the Snipd Podcast app to discover more snips from this episode

Get the app

The One Big Beautiful Bill Act is projected to cut Medicaid spending by more than $1 trillion. The law changes eligibility rules, and some predictions estimate at least 10.5 million people will be eliminated from the program.

“For some adults, Medicaid will step in and help pay for care at home, or if care at home is not available, for care in nursing homes,” said Rachel Werner, executive director of the Leonard Davis Institute of Health Economics at the University of Pennsylvania. “With the cuts to Medicaid funding, we are expecting that the availability of care in both of those settings will diminish, and it will be harder for people to get the care they need to live independently.”

States will have to respond to the changes by either making up the funding gap or reducing services.

On the show today, Werner explains how the funding cuts could limit the caregiving options for older Americans who need at-home care and place a larger responsibility on their families. Plus, we discuss how to start planning for long-term care amid all the legislative changes.

Then, we’ll celebrate a listener’s win about her chocolate lab puppy. And, another listener’s quest to find life on Mars.

Here’s everything we talked about today:

“How Medicaid Cuts Could Force Millions Into Nursing Homes” from The Leonard Davis Institute of Health Economics at the University of Pennsylvania
“Advocates warn that Medicaid cuts in the big budget law put home-based health care at risk” from Marketplace
“New AARP Report: Majority of Adults 50-plus Want to Age in Place, But Policies and Communities Must Catch Up” from AARP
“A Closer Look at the Medicaid Work Requirement Provisions in the “Big Beautiful Bill” from KFF
“Medicaid cuts: The how and why” from the newsletter Your Local Epidemiologist
“As the need for nursing homes grows, nurses are in short supply” from Marketplace

We love hearing from you. Leave us a voicemail at 508-U-B-SMART or email makemesmart@marketplace.org.