Introduction to Medicaid Cuts
Delinda Phillips has cared for seniors in some capacity since she was a child, tagging along with her mother, who worked as a home healthcare worker. Phillips, 55, of Chicago, has been in the healthcare industry for the past 26 years and works as a certified nursing assistant at a nursing home in Oak Lawn, and she’s worried about what the looming Medicaid cuts will mean for patients she cares for and for her career. “As a nursing home worker, I’m worried about it, the seniors I care for [have] Medicaid,” she said. “I’m not going through this job to get wealthy, I’m doing it out of love.”
Impact on Nursing Homes and Long-Term Care Facilities
Experts and advocates in Illinois say the sweeping Medicaid cuts approved by House Republicans could have devastating effects on low-income seniors and people with disabilities living in nursing homes and other long-term care facilities. U.S. House Republicans’ proposed legislative package cuts $700 billion from the Medicaid program and changes eligibility requirements that call for states to check enrollee eligibility every six months rather than on a yearly basis, the Associated Press reported. The package lawmakers have named the “One Big Beautiful Bill Act,” will head to the U.S. Senate where it is expected to face challenges.
U.S. Speaker of the House Mike Johnson (R-LA) speaks to the media after the House narrowly passed a bill forwarding President Donald Trump’s agenda. The tax and spending legislation, called the “One, Big, Beautiful Bill” Act, redirects money to the military and border security and includes cuts to Medicaid, education and other domestic programs.
Effects on Residents and Staff
Advocates worry less funding will lead to a reduced quality of care at nursing homes while other facilities could close altogether. Many residents of nursing homes are elderly, but there are also people who are in their 50s and 60s who have a physical or developmental disability that requires more care than what can be provided by home-care services, said Ron Nunziato, the senior director of policy for the Health Care Council of Illinois. Medicare, a federal insurance program for people 65 years or older, only covers 100 days in nursing homes while Medicaid, a federal and state program, covers the cost for longer stays in nursing homes, Nunziato said.
Medicaid Funding and Usage
About 70% of all the days a person spends in a nursing facility in Illinois are covered by Medicaid, and in fiscal year 2024 that amounted to $3.8 billion in federal dollars for long-term care facilities, according to the Illinois Department of Healthcare and Family Services. “Federal cuts to Medicaid will leave state and local governments with vast budget shortfalls that cannot be made up, and the direct result would not only mean an economic impact for communities but also one directly felt by Medicaid customers currently residing in nursing facilities – and those served throughout the Medicaid program,” the department said in a statement.
Delinda Phillips, 55, of Chicago, works as a certified nursing assistant at a nursing home in Oak Lawn and is concerned about what cuts to Medicaid will mean for patients she cares for and her career. She is a union steward for SEIU HCII.
Staffing and Care Quality
The bill will place a moratorium on an effort to increase staffing levels at nursing homes, said Gelila Selassie, an attorney with Justice in Aging. Staffing levels at nursing homes are important because they prevent deaths at facilities, she said. The rule would have required an around-the-clock registered nurse and a minimum of 3.48 total nurse staffing hours per resident per day, according to an KFF analysis. Phillips, who is also a union steward for SEIU HCII, said nursing homes are already short-staffed. She typically cares for 13 to 15 seniors every shift, and she almost always ends up working overtime hours because of staffing shortages. She worries cuts to Medicaid will mean she will have an even higher load of seniors to take care of every shift.
Potential Facility Closures
Nursing homes have already faced financial struggles, Nunziato said and pointed to the closure of 50 facilities in Illinois in the last five years. He thinks even more could close. “When those facilities close, it’s not just a business, it’s not just employees losing their jobs, it’s residents having to relocate the home that they may have been in for five years, three years,” Nunziato said. “It’s putting a strain on families.”
Impact on People with Disabilities
Another provision in the bill limits retroactive coverage from three months to one month, said Selassie. Applying for Medicaid requires a lot of paperwork and Selassie said now families will have
