Seniors to Feel the Brunt Shortening the Time to Apply for Medicaid

The impact of the One Big Beautiful Bill Act (OBBBA) on Medicaid services for seniors has become clear.  While most of the news coverage has focused on work requirements for people between the ages of 19 and 64 and on immigrants, seniors will be hit hard.  Here are examples.

Reduction in Retroactive Medicaid Eligibility Coverage

For decades, states provided Medicaid beneficiaries with up to 3 months of retroactive Medicaid coverage if the individual would have been otherwise eligible during that time period. Beginning January 1, 2027 the period will be reduced to 2 months. This will impact folks in two categories. Those who have certain Medicare Advantage policies may experience enormous medical bills after an emergency hospitalization and post hospital care such as an extended stay in a nursing home. Moreover Medicare will only cover 30 days of “skilled care” in a nursing home. A patient may need extended skilled and personal care services before returning to home. The bills that can be enormous.

Currently Medicaid will pay these bills if a person applies with in 90 days of the services. The delay in the bill can be significant.  The 90 day allowance gives the patient time to recover and “spend down” to Medicaid eligibility. In our experience most people are shocked at the size of the bill and have to scramble to “spend down” to apply for Medicaid. Shortening this period to 60 days will mean many more seniors will have large unpaid medical bills.

This shortening the time to apply also applies to the Medicaid Home and Community Bases Services programs. In Michigan the primary program is called “MiChoice Waiver.” It covers long-term care services for recipients in their own home or a community setting, rather than a nursing home. Services can include adult day health, home-delivered meals, transportation, chore services, nursing services, home modifications, respite care for caregivers, This program very often prevents a senior from returning to a nursing home.

Reduction in Home Equity Maximum

The maximum home equity allowance will be one million dollars.  This provision affects a surprising number of middle class seniors. Many who purchased a nice home decades ago have found that inflation has driven up the value of their home. But their money in the bank did not! Needless to say there are many cases where a senior needs help in home and cannot pay for it. Medicaid provides Home and Community Based Services necessary to avoid going into a nursing home.  This home equity cap will prevent them from getting help in home or the nursing home.  We must add that there are strategies to avoid forced sale of the home, but that now means many more seniors will have to hire an attorney just to live in their own home!

There is still time to act. Contact your Representative in Congress and your Senator and inform them that you oppose the limitation of coverage for seniors. And don’t foreget to vote in the 2026 federal elections!