Senate Passes “One Big Beautiful Bill”: What It Means for Your Long-Term Care Plans
At Estate Planning Law Center, we understand that keeping up with Medicaid legislation isn’t just for policymakers, it’s for families. If you’re caring for an aging loved one or planning ahead to protect your own legacy, what happens in Washington directly affects your peace of mind.
This week, we’re focusing on major developments that could change the way long-term care Medicaid works for millions of Americans including right here in New York.
What Happened?
On July 1, 2025, the U.S. Senate narrowly passed President Trump’s “One Big Beautiful Bill,” a sweeping package of healthcare and Medicaid-related reforms. The vote was split 50–50, with Vice President Vance casting the deciding vote.
This amended version of the bill now returns to the House of Representatives, where final negotiations will take place. But if passed, these changes will impact how and when individuals can qualify for Medicaid, especially for long-term care.
Here’s what you need to know if you’re a homeowner, a caregiver, or simply planning ahead.
What’s Changing and Why It Matters to You
1. Recertification Requirements Double
Current rule: Medicaid recipients must confirm their eligibility annually.
Proposed change: This would increase to twice per year.
Why it matters:
This shift adds more paperwork and increases the chance of lapses in coverage, especially for seniors and their families already overwhelmed by care decisions. State agencies are already facing backlogs, and this could slow approvals even further. In New York, the average Medicaid processing time is already 45–90 days depending on the county.
2. Home Equity Limits Tightened
Current rule: States set their own home equity caps for Medicaid eligibility—New York’s limit is currently $1,071,000.
Proposed change: A flat national cap of $1,000,000, with no adjustments for inflation.
Why it matters:
For many Upstate New York families, the value of the family home has increased over the years. Under this rule, those who exceed the cap, even by a few thousand dollars, could be denied care unless they’ve planned appropriately. Without legal guidance, you may be forced to sell or risk ineligibility.
3. Retroactive Coverage Narrowed
Current rule: Medicaid can retroactively cover up to 3 months of medical expenses before an application is submitted.
Proposed change: That window shrinks to 30 days.
Why it matters:
If your loved one enters a nursing home and you don’t apply immediately, you could be on the hook for tens of thousands of dollars in care costs. The average monthly cost of a nursing home in New York is over $13,000. With just 30 days of retroactive eligibility, a delay in applying could cost your family significantly.
See cost data: Genworth Cost of Care Survey 2024
4. Provider Tax Changes Affecting Access to Care
While this may sound like legislative jargon, the reality is this: hospitals and care facilities—especially in rural communities—could lose funding. That could mean fewer options for families in need of long-term care.
The bill includes a new $25 billion rural hospital fund, but it’s uncertain how or when those funds would be distributed.
5. Home and Community-Based Services (HCBS) May Expand
Current rule: These services are available only to those who meet an institutional level of care.
Proposed change: States may soon be allowed to offer HCBS to individuals before they need full-time nursing care.
Why it matters:
For families hoping to keep aging loved ones at home longer, this could be a meaningful opportunity. However, no new programs will be approved before July 1, 2028, and rollout timelines remain uncertain.
What are HCBS services? Learn more from Medicaid.gov
What Should You Do Now?
Even though the bill isn’t final, these proposed changes signal one clear message: Medicaid is getting more complex, and the window to act is shrinking.
At Estate Planning Law Center, we help families understand the rules—and create strategies that protect what matters most: your home, your savings, and your independence.
Our process helps clients:
- Avoid costly penalties
- Protect the family home
- Keep loved ones out of institutional care as long as possible
- Qualify for Medicaid without giving everything away
- Sleep better at night knowing they have a plan in place
Planning Ahead vs. Reacting in Crisis
If you’re reading this after a hospital stay or sudden diagnosis, you’re not alone. But the truth is: the best time to plan is now, not when you’re already in crisis.
Without proper planning, the financial burden often falls on family members—who may find themselves draining retirement accounts or selling family property just to keep up.
We want to help you avoid that.
Take the Next Step
Whether you’re looking to protect your own future or help aging parents stay in control, our team is here to guide you.
Here’s how we can help:
- Attend a free estate & long-term care planning workshop
Register here for upcoming dates - Download our free Medicaid Planning Guide
Get your guide now - Schedule a private Vision Meeting
Let’s talk about your unique goals and how we can help you build a plan that fits your life.
Because When It Comes to Your Family, Medicaid Planning Isn’t Optional
There’s a lot of noise in the news. But here’s the bottom line:
If this bill becomes law, it will change the rules for families across New York.
Don’t wait for the government to make a decision before you do. Let’s start the conversation today.
Call or text Estate Planning Law Center at (315) 793-3622 or visit us at www.eplawcenter.com
