Federal Policy Shifts & Funding Pressures in 2025

■ One Big Beautiful Bill Act (OBBBA):

• The new federal reconciliation law could significantly cut Medicaid funding over the next decade, with direct implications for long-term care (especially nursing facilities and HCBS) as states adjust to reduced federal support. Federal changes also affect payment structures used by Medicaid to reimburse providers. Read more here.

■ Growing Advocacy on Medicaid Funding:

• LTC provider groups (e.g., AHCA/NCAL) are emphasizing that Medicaid underfunding threatens nursing homes and assisted living communities. Providers warn that deep cuts could force closures, reduced staffing, or fewer Medicaid beds. Read more here.

■ Broader Medicaid Spending Growth:

• Despite flat enrollment expectations, Medicaid spending overall is rising — driven in part by higher costs for long-term care and other services. This trend puts fiscal pressure on states’ LTC budgets.