On July 4, 2025, Congress passed President Trump’s One Big Beautiful Bill (OBBB), a sweeping package including healthcare and Medicaid-related reforms that will significantly alter New York’s healthcare landscape. For many New Yorkers receiving or applying for long-term care Medicaid, eligibility criteria will change only slightly; however, the overall system is becoming more complex. While many provisions are set to take effect in the coming years, some Medicaid-funded programs are expected to experience short-term funding losses.
Here are some key takeaways:
- Home Equity Cap (2028): Medicaid eligibility will include a fixed national home equity limit of $1 million—slightly below New York’s current cap of $1,097,000.
- Shortened Retroactive Coverage (2027): Coverage will extend only 2 months prior to application (1 month for New York State of Health enrollees).
- Potential Expansion of Home-Based Services: Beginning in July 2028, the OBBB allows states to apply for a new federal waiver to cover home and community-based services (HCBS) as medical care. This could expand access to in-home support for individuals before they meet the strict criteria for nursing home care.
- Delay in Nursing Home Staffing Requirements: Enforcement of federal staffing standards is postponed until 2034.
- New Rules for Medicaid Expansion Enrollees Only: These include work requirements and more frequent eligibility reviews, which do not apply to most elderly or disabled long-term care recipients.
What You Should Do
While most of the core eligibility rules remain in place, the path to qualifying and maintaining benefits is narrowing. Planning early helps avoid surprises down the road.
📞 Call us at 516-328-2300 ext. 304 or email [email protected] to discuss how these changes may affect you or your family.
We are here to help you navigate these significant changes.
