Big Beautiful Bill expected to cause thousands of senior deaths

The recently passed One Big Beautiful Bill is sure to have an effect on Americans everywhere, one place being the senior care industry. The bill contains provisions to make senior care more dangerous and expensive, yet simultaneously more needed.

Anyone who has a loved one in a nursing home should be aware of the OBBB’s swift reduction in the number of nurses required to be on staff in nursing homes at all times. Lori Smetanka, the executive director of the National Consumer Voice for Quality Long-Term Care, explained that, “This means that many current and future nursing home residents will not receive the care they need, or will be harmed, because there are not enough staff available.” Smetanka also warned, “It is estimated that 13,000 lives will be lost each year due to understaffing. Understaffing puts residents at increased risk of abuse and neglect. It also increases the risks to workers of injury and harm.”

Anyone who has experience with the long-term care industry is already aware of the chronic understaffing that plagues nursing homes. After countless avoidable deaths, injuries, and nurse and patient suffering, the Biden administration sought to end the understaffing and implemented minimum staffing standards for nursing homes. Among other requirements, nursing homes were suddenly required to always have a registered nurse accessible to the residents. This was a step in the right direction of curbing nursing homeowners’ greed and prioritizing the well-being of vulnerable adults.

However, the OBBB will delay implementation of Biden’s law and leave seniors and disabled adults even more vulnerable than before. Worse, an increase in immigration raids is exacerbating the low staffing issue even more so, as its estimated that about a quarter of senior care staff are immigrants.

In addition to making senior care more dangerous, the OBBB will always make it far more expensive and inaccessible. Because of the complicated process of applying for Medicaid, older adults were allowed to receive payment for their care for up to three months before being approved. This is to ensure adults aren’t having to pay out of pocket or go without care simply because of the long application process.

The changes in OBBB have reduced this retroactive payment to two months instead of three. Meanwhile, the process has stayed just as complicated, and the government is permitted to take just as long to approve applicants. As Smetanka explained, “This will make it harder for adults to get and maintain Medicaid coverage by allowing states to maintain bureaucratic requirements, such as complex income verification paperwork and frequent renewals that currently prevent eligible people from gaining and maintaining coverage.”

Further, the new law will soon cap the amount of home equity many individuals can have in order to qualify for Medicaid long-term care coverage. “By capping the amount of equity in a home, and not adjusting for inflation, this law could force an older adult to sell their home in order to qualify for Medicaid,” Smetanka said.

Additionally, the OBBB is expected to result in other long-term care programs, such as home and community-based care, so even more people will be forced to search for care in nursing homes. This will come after the law that limits the taxes states can impose on Medicaid providers, as the lack of funding will force states to cut benefits or eligibility categories. “Home-and community-based services account for the majority of optional spending and are likely to be cut first, leading to longer waiting lists and more institutionalization.”

Of course, this increase in demand will come at a time when nursing homes have been made more understaffed than ever.