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UNDERSTANDING MEDICAID
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Understanding Changes to Medicaid Long-Term Care in Pennsylvania and the Impact on Caregivers
The recent federal One Big Beautiful Bill Act( OBBBA) legislation signed into law on July 4, 2025, brings significant changes to how Medicaid funds long-term care services. For families caring for aging parents or loved ones with disabilities, these changes may affect access to nursing home care and home-based services that many Pennsylvania residents and their families rely on.
These changes represent a significant shift in how long-term care services are funded and delivered, making it more important than ever for families to understand their options and plan accordingly.
What’ s Changing
The Congressional Budget Office estimates that the enacted legislation will reduce federal Medicaid spending by over $ 1 trillion over the next decade. Since Medicaid currently pays for about 60 % of extended nursing home stays nationwide and covers nearly 1 million residents, these funding changes will likely impact how states manage their long-term care programs.
The legislation also includes new restrictions on provider taxes that states use to generate additional federal matching funds, potentially reducing resources available to nursing homes and other care providers.
Impact on Different Types of Care
Nursing Home Care: With reduced federal funding, states may need to adjust reimbursement rates or modify covered services. Nearly two-thirds of nursing home residents currently depend on Medicaid for their care.
Home and Community-Based Services( HCBS): About half of Medicaid spending on older adults goes to HCBS, which helps over 4.5 million people receive care at home. Pennsylvania’ s HCBS waiver programs may face particular challenges since these services are optional under federal law and can be more easily modified than institutional care.
Family Caregivers: Changes to available services may increase caregiving responsibilities for family members, along with associated financial and emotional considerations.
Pennsylvania’ s Long-Term Care Funding
Pennsylvania’ s Medicaid long-term care program continues to be jointly funded by federal and state dollars, though with modified federal contributions. Pennsylvania will continue using a combination of state general revenue, county funds, and certified public expenditures for its share. Individuals in nursing homes will still contribute a portion of their income toward their care costs.
Moving Forward
For families navigating long-term care decisions, it’ s important to stay informed about how changes may affect available options. Discuss your estate planning options and asset protection strategies with Zacharia Brown & Bratkovich attorneys, and care plans with healthcare providers to explore all available resources.
This Industry Insight was written by Justin Ellis. Justin is an Associate Attorney at Zacharia Brown and counsels clients in estate and asset protection planning, Medicaid eligibility for long term care, Veterans’ benefits eligibility, and estate administration. He also represents clients in Orphans’ Court litigation, including guardianship proceedings for incapacitated adults. Justin regularly represents hospitals and nursing homes to secure medical and financial decision makers for patients in need of such individuals. Pittsburgh-area office locations include McMurray, Murrysville, McKeesport and Wexford. Contact information – Phone: 724.942.6200 Website: zacbrownlaw. com E-mail: jellis @ zacbrownlaw. com
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