How Will Medicaid Cuts In The “Big Beautiful Bill” Impact Home Care?

Jacob Taitel

Jul 9, 2025

3 min

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As of July 4th, the Senate reconciliation bill has been signed into law. It represents a sweeping set of changes in national priority, including a set of major cuts to Medicaid which have caused pushback from across the healthcare industry.

Various organizations including the American Medical Association and the National Rural Health Association have released statements describing ways that the new law will limit care available to vulnerable populations; additionally, various hospital systems and nursing homes, especially in rural areas, have already announced closures due to lack of future funding.

The New Law’s Risks To Home Care

The question on everyone’s mind: will the law affect home care to the same degree as other healthcare sectors?

Here’s what we know:

Large amounts of money are being taken out of Medicaid funding, specifically for those who are on Medicaid as part of Medicaid expansion.
This is primarily being accomplished through work requirements for people aged 19-64.
States will be receiving less money from the federal government.
Medicaid recertifications will happen every six months instead of the current annual system.

Nuance & Considerations

However, there are nuances to consider regarding its impact in home care:

People 65 or older and under 19 won’t have work requirements.
There are special provisions for those with certain disabilities that will waive the work requirement.
States are in charge of administering Medicaid, meaning that the details will likely vary widely from state to state.

Because work requirements are a core mechanism of the budget cuts, some of these points seem to suggest the impact on in-home care providers (whose clients are generally over 65) may be lessened in some respects relative to other healthcare providers.

The Main Headlines

So, what are the takeaways?

Many people are going to lose Medicaid coverage either from work requirements, added red tape, or direct budget cuts.
Providers will need to ensure that they are running proper eligibility checks for Medicaid clients.
Providers should be prepared for states to potentially pull back on hours and/or for reimbursements to be reduced or stagnate.
Providers need to stay closely in tune with state Medicaid organizations and increase their focus on compliance.