Pennsylvania’s disability, long-term care facilities prepare for Medicaid cuts

The Trump administration’s 2025 Budget Reconciliation Act, also known as the “One Big Beautiful Bill,” includes major changes and cuts to health insurance programs like Medicare and Medicaid, which cover seniors and people with low incomes, including people with disabilities.

Supporters of the act claim that the changes should not affect vulnerable populations who depend on these programs, but Pennsylvania health policy experts and disability advocates say that’s highly unlikely.

“I think there is a lot of reason to be concerned that vulnerable people in our community are going to suffer as a result of this bill,” said Dr. Rachel Werner, executive director of the Leonard Davis Institute of Health Economics at the University of Pennsylvania.

Predicted funding losses at long-term care facilities

Many people who use wheelchairs, need high levels of daily care and who can’t work to fully support themselves financially because of disabilities will remain eligible for Medicare and Medicaid.

They won’t lose their health insurance, but experts predict that Pennsylvania will receive fewer federal Medicaid dollars overall in the coming years because of cuts to other populations and parts of the program.

As a result, the state may cut payment rates to nursing homes across the commonwealth, which could force some nursing facilities to lay off staff or freeze hiring and wages, cut optional health care services and scale back activities and programs for residents, Werner said.

“Which is all very concerning, because it reduces quality of life for residents,” she added.

A facility may also reduce its census, or the number of beds and people it serves.

“Because they’re going to lack the staff and the ability to care for those residents in a safe manner,” Werner said. “This is going to further reduce the revenue nursing homes have and ultimately could lead to nursing homes closing.”

These are the scenarios that Inglis is fighting to prevent, said Dyann Roth, president and CEO. The organization has been regularly fielding calls and questions from residents and their families concerned about how care could change at the facility.

Leaders and providers are worried, too, Roth said, because the stakes are high.

“We have human beings’ lives at risk,” she said.

The goal is to keep as many services and people as possible, Roth said. In order to do that, she said that Inglis has to prepare as best as possible for funding losses.

“We have to look at contingency plans for the future to mitigate the effects that we know are going to come. We just don’t know when and to what degree,” she said.

Plans involve looking into opportunities to bring in more money from other kinds of insurance programs and revenue streams, without spending more to do so.

It can also include using technology to supplement or support care, and find more efficient ways to provide existing services.

“Because the cost is just going to keep going up,” Roth said. “But I think it’s when we do our most innovative work.”