How could Medicaid cuts affect long-term care?

Jul 15, 2025

Rachel Werner, the Executive Director of the Leonard Davis Institute of Health Economics at the University of Pennsylvania, dives deep into the potential fallout from projected Medicaid cuts. She warns that over 10 million people could lose access to crucial home and nursing care. The discussion highlights the strain these changes would place on families and necessitates proactive long-term care planning. Alongside this critical topic, the episode also celebrates a listener's adorable chocolate lab puppy and explores the quest for life on Mars.

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INSIGHT

Medicaid Funding Cuts Explained

Medicaid cuts mainly come from limits on provider taxes that states use to fund Medicaid.
This reduces federal matching funds, leading to a significant Medicaid budget cut.

INSIGHT

Medicaid's Role in Long-Term Care

Medicaid is crucial for funding long-term care at home and in nursing homes.
Cuts will reduce availability of these care options, making independent living harder.

INSIGHT

Funding Cuts Impact Care Settings

Nursing home care is mandatory in Medicaid, so cuts may lower nursing home payment rates or eligibility.
States might reduce home-based services, shifting care burdens to families and possibly increasing nursing home admissions.

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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

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