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Changes Ahead

By Gail Glockhoff-Long
GolderCare Solutions
Benefits Advocate

Congress has passed a new federal budget. Like many large pieces of legislation, it covers everything — possibly even the kitchen sink. Whenever a bill of this size is passed, I find myself wondering how many members of Congress actually read it and truly consider its real-world consequences.

One of the most significant consequences of this Big Beautiful Bill — as some are calling it — will be the effect on state programs. Much of what the federal government funds flows through block grants and other transfers to the states, and from there, to the people who depend on these programs.

We don’t yet know all the ripple effects this legislation will have, but we do know this: major changes are coming, especially in healthcare and elder services. While I’ll leave the tax changes to the accountants, I want to focus here on what this means for seniors, disabled individuals, and their families. Some of the changes take effect as early as 2026, others by 2028.

Medicaid

If you’ve ever talked to someone who’s gone through the Medicaid application process, you already know it can be long, intrusive, and exhausting. At GolderCare, we work mostly with clients in nursing homes or supportive living communities. Currently, Medicaid is the primary payer for 63% of nursing home residents, while another 13% receive short-term coverage through Medicare for rehab stays.

Federal payments to states for Medicaid are expected to shrink under the new budget. Those funds pay for nursing home staff, meals, activities, therapy, medical supplies, and building maintenance. If those dollars go away, how will your local facility make up the difference?

Today, Medicaid recipients must reverify their eligibility once a year. Even that has been hard to manage. Illinois, for example, is so far behind in processing that it can take months to get a new application or renewal approved. Iowa is faring better, but even so, we find that most of the decisions we receive contain errors — from incorrect denials to misapplied penalty periods — all of which must be appealed.

Unfortunately, the new law will double the reverification requirement, mandating it twice a year instead of once. It also requires states to verify work requirements, even for some Medicaid recipients who are elderly or disabled. If forms are not completed accurately, on time, and with supporting documents, you could lose your coverage — even if you otherwise qualify.

GolderCare provides individualized care and benefits advocacy and coaching to assist seniors and their families as they navigate the aging process. Gail is a Benefits Advocate with GolderCare Solutions, helping families navigate the complexities of aging, care, insurance, placement, and public benefits.