Instant Insight

30-Second Take

• Republicans’ proposed Medicaid cuts could severely impact nursing home care, affecting millions of older adults and people with disabilities.
• The cuts, totaling $625 billion over 10 years, would reduce access to critical long-term care services and potentially lead to staffing shortages in nursing facilities.
• These changes could trigger additional cuts to Medicare and other programs supporting older adults and people with disabilities.

Quick Brief

2-Minute Digest

Essential Context

Medicaid is the primary payer for nursing home care in the United States, covering over 70% of long-term care services. The proposed Republican budget reconciliation bill includes significant cuts to Medicaid, which would have far-reaching consequences for nursing home residents.

Core Players

• Republican Party – Proponents of the budget reconciliation bill
• Congress – Currently debating the bill in the Senate
• Nursing Home Residents – Directly affected by potential Medicaid cuts
• Healthcare Advocacy Groups – Opposing the cuts due to their impact on care access

Key Numbers

• $625 billion – Estimated Medicaid cuts over 10 years
• 10.3 million – People who could lose their Medicaid coverage
• 71 million – Number of people insured by Medicaid as of December 2024
• $45 billion – Projected Medicare cuts for fiscal year 2026 due to S-PAYGO

Full Depth

Complete Coverage

The Catalyst

The Republican-led House passed a budget reconciliation bill on May 22, 2025, which includes substantial reductions in Medicaid funding. This move is part of a broader fiscal agenda that aims to make permanent tax cuts enacted in 2017 and fund other initiatives.

This bill now heads to the Senate, where it faces significant scrutiny and opposition.

Inside Forces

The proposed cuts would shift long-term care costs to states, likely resulting in reduced funding for Home- and Community-Based Services (HCBS) and other critical care programs. This could lead to gaps in care and make it harder for people to qualify for Medicaid coverage.

The bill also repeals the Nursing Home Minimum Staffing Rule, which could compromise the quality of care in nursing facilities due to inadequate staffing.

Power Dynamics

The Republican Party’s push for these cuts is met with strong opposition from healthcare advocacy groups and Democrats, who argue that these reductions would devastate nursing home residents and undermine the healthcare system.

Healthcare providers and nursing home operators are also concerned about the potential impact on their ability to provide quality care.

Outside Impact

The broader implications of these cuts extend beyond nursing homes. They could trigger massive cuts to Medicare and other programs supporting older adults and people with disabilities due to the Statutory Pay-As-You-Go Act of 2010 (S-PAYGO).

This could lead to a significant reduction in healthcare access and quality for vulnerable populations.

Future Forces

As the bill moves to the Senate, there will be intense debate and lobbying from various stakeholders. Healthcare advocacy groups are urging the public to contact their lawmakers to express opposition to the cuts.

The outcome will depend on the Senate’s deliberations and the public’s response to these proposed changes.

Data Points

• May 22, 2025: House passes the budget reconciliation bill
• 61%: Medicaid’s share of all long-term care costs in 2022
• 70%: Medicaid’s share of Home- and Community-Based Services (HCBS)
• $880 billion: Total Medicaid cuts proposed over a 10-year period
• 36%: Public support for the bill according to a YouGov poll