Examining the Effects of Health Care Reform on Legal Structures
The recent health care reforms, notably the 2025 Budget Reconciliation Act, also known as the "One Big Beautiful Bill" (OBBB), have had significant and concerning impacts on elder law and the rights of elderly individuals.
One of the most notable effects is the major Medicaid cuts and restrictions. The Act imposes the largest historical cuts to Medicaid and the Supplemental Nutrition Assistance Program (SNAP), putting at risk the health and financial security of millions of older adults by reducing available coverage and benefits. These cuts may force older homeowners to delay or forgo needed long-term care or even sell their homes to qualify for Medicaid.
Another impact is the increased administrative burdens. Medicaid now requires biannual eligibility redeterminations, increasing paperwork and the chance of benefits lapsing due to administrative errors. States must verify enrollment more often, and new work requirements for Medicaid and SNAP apply to certain non-Medicare-eligible people under age 65, including some older adults.
The reduced retroactive Medicaid coverage is another concern, as the retroactive coverage period has been shortened from three months to two months (or 90 days to 30 days in some contexts), limiting older adults' ability to cover prior medical costs when Medicaid enrollment is delayed.
The changes also have impacts on nursing home care. Cuts in Medicaid funding have led to expected staffing reductions in nursing homes, which directly affects the quality of care for elderly residents. Reduced staff levels raise risks for neglect, abuse, medical errors, and increased use of chemical restraints. Additionally, the legislation blocks previously proposed federal minimum staffing standards intended to improve nursing home care quality.
Moreover, the OBBB restricts Medicare-related programs. The law blocks improvements to Medicare Savings Programs that assist lower-income seniors with premiums and out-of-pocket costs, reducing affordability and access. Furthermore, the Act excludes "orphan drugs" (used for rare diseases) from Medicare's negotiated drug pricing, potentially increasing medication costs for some elderly patients.
These changes collectively threaten the legal rights and protections older Americans have relied on for health care access, long-term care, and economic security. Advocacy groups warn that the reforms undermine promises of support for aging populations and will disproportionately harm those with low incomes or disabilities.
Despite these challenges, advocates continue to work towards policy changes that benefit elder populations, particularly regarding Medicaid and Medicare reforms. Health care reform seeks to improve the quality of care through measures such as incentivizing value-based care and utilizing evidence-based practices. Advocates also educate clients about their rights in health care decision-making, empowering elders to make informed choices and ensure their preferences are respected.
The Affordable Care Act (ACA) introduced essential reforms, including the establishment of health insurance marketplaces, expansion of Medicaid, and mandates requiring individuals to obtain insurance. Additionally, telemedicine has emerged as a significant technological advancement, allowing elderly patients to consult health care professionals remotely.
In conclusion, while recent health care reforms have introduced harsher eligibility criteria, increased bureaucratic hurdles, cut funding to critical elder care programs, and weakened protections for nursing home residents, advocacy and technological advancements continue to strive for a better and more equitable health care system for all elderly individuals in the U.S.
- In the context of health and wellness, the increased administrative burdens, such as biannual eligibility redeterminations and new work requirements, imposed by the One Big Beautiful Bill (OBBB) on Medicaid and SNAP can create challenges for older adults.
- The changes in medical-conditions management under the OBBB, like the shortened retroactive Medicaid coverage period and restrictions on Medicare-related programs, may have a significant impact on the healthcare access and affordability for low-income older adults, particularly those with rare diseases.
