The “Big Beautiful Bill”: What It Could Mean for Your Long-Term Care Planning
There’s a new federal law on the books—known unofficially as the “Big Beautiful Bill”—that could significantly reshape the future of Medicaid, particularly for individuals and families who may someday rely on it to cover long-term care expenses. Several provisions in the bill deserve attention, especially if you or a loved one may need skilled nursing care in the future.
Below is a breakdown of some of the most important changes, how they may affect your access to care, and what it means for those planning ahead.
Home Equity Cap Frozen at $1 Million
Currently, Medicaid excludes a portion of a person’s home equity when determining eligibility for long-term care benefits. In 2025, states are required to set this home equity limit somewhere between $730,000 and $1,097,000, with the actual amount varying by state and adjusting annually for inflation.
The new bill would set a single nationwide cap of $1,000,000, effective January 1, 2028, and freeze it permanently. That means it will no longer increase with inflation. While a million-dollar home may seem generous now, real estate values continue to rise. A home that’s exempt today could push someone over the limit just a few years from now. This provision could particularly impact homeowners in urban or coastal areas.
If your home is a large portion of your wealth this change makes early planning critical. Without proper steps in place, more of your home’s value may be counted against you in a future Medicaid application.
Reduced Retroactive Coverage
Currently, Medicaid can cover qualifying medical expenses going back up to 90 days before a person applies. This retroactive coverage is a critical safety net when someone enters a nursing home unexpectedly. The new bill would shorten that window to just 30 days.
Timely Medicaid applications will become even more important. Delays—even by a few weeks—could leave families responsible for thousands of dollars in uncovered care.
Potential Strain on Nursing Homes
The bill includes major reductions in federal Medicaid funding, and providers are warning that these cuts could lead to serious challenges. Some nursing homes, especially in rural or underfunded areas, could be forced to reduce services, delay maintenance, or even close altogether.
A now-overturned staffing regulation aimed to improve care by requiring around-the-clock RN coverage and minimum staffing levels. Though that rule has been blocked for now, the funding pressure remains. At the same time, the bill places a moratorium on provider taxes, which states have historically used to boost Medicaid funding.
While these behind-the-scenes funding changes may not be obvious right away, they can affect care quality, bed availability, and wait times. It will become even more important to identify reliable long-term care providers early in the planning process.
Now that the “Big Beautiful Bill” is finalized, the direction is clear: Medicaid eligibility and benefits will be harder to secure in the future, and the quality of available care may become more uneven.
That’s why proactive planning—before a health crisis hits—is more important than ever.
- Review your home equity and consider options to protect it if you plan to rely on Medicaid someday.
- Make sure your legal documents (like powers of attorney and trusts) are up to date and aligned with current rules.
- Talk with your attorney about your long-term care plan—whether for yourself or a loved one—and explore options that provide flexibility under tightening rules.
We are committed to helping you stay informed and prepared, no matter how the rules evolve.
