The new Trump administration is considering significant changes to Medicaid that could impact access to long-term care coverage for millions of Americans. Medicaid is the primary payer for long-term care services, including nursing home care, supporting over 70 million individuals. The most likely changes include a reduced federal share of state Medicaid programs (FMAP) as well as potential caps on total spending for certain demographic groups – including seniors.

Proposed Changes to Medicaid

Recent reports indicate the administration plans to implement substantial funding cuts to Medicaid. These reductions are part of broader efforts to decrease federal spending and likely involve regulatory changes aimed at shrinking the program’s scope.

Impact on Long-Term Care Coverage

The proposed funding cuts and policy changes could have several significant impacts on long-term care coverage:

1. Reduced Access to Services: With decreased funding, states may be forced to limit the availability of long-term care services, making it more challenging for individuals to receive necessary care.
2. Increased Financial Burden: Cuts to Medicaid could result in higher out-of-pocket expenses for individuals requiring long-term care, potentially leading to additional financial hardship for low-income families. Home and community-based supports (HCBS) will most likely become increasingly limited, and there is a strong likelihood of stricter enrollment caps, as these waivers are already optional benefits states can incorporate into Medicaid. Long-term care and nursing home facilities are required based on federal Medicaid guidelines; however, this care is more expensive for beneficiaries than HCBS.
3. Strain on Healthcare Providers: Reduced reimbursement rates may lead to financial difficulties for long-term care facilities, potentially resulting in closures or reduced quality of care – which could further limit access for care recipients.
4. Eligibility Restrictions: The administration may encourage states to implement new waivers including work requirements and additional eligibility restrictions, potentially shrinking the eligible population, and limiting access to Medicaid for vulnerable populations.

The potential changes to Medicaid under the Trump administration could significantly impact long-term care coverage, affecting access to home services, financial stability for individuals and providers, and overall quality of care. It is crucial for stakeholders, including policymakers, healthcare providers, and beneficiaries, to stay informed about these developments, and advocate for policies to ensure the continued support of aging adults and those in need of long-term care services. Additionally, the private sector may have an expanded role to play in better addressing the needs of low-income populations through new plan models prioritizing access to home care resulting in more affordable and accessible options for low-income households.