“Nearly 70% of Georgia’s nursing home patients depend on Medicaid. What if that safety net is in jeopardy?” A wave of fear is sweeping Georgia’s elder care population, and rightly so. According to a recent Brown University School of Public Health report, 37 nursing homes in Georgia are now at risk of being shut down due to a staggering $1 trillion worth of Medicaid reductions detailed in the recently passed federal spending bill. That’s not a number, it’s a blow to thousands of at-risk seniors and their families.
1. The Numbers Behind the Crisis
The Congressional Budget Office has estimated that the Medicaid budget is going to be reduced by $1 trillion over the next decade, with effects felt in full force starting in 2027 or 2028. Georgia ranks in the top five states most at risk, with five facilities in the Atlanta region, Arrowhead Health and Rehab, PruittHealth, Meadowbrook Health and Rehab, Healthcare at College Park, and Sadie G. Mays Health and Rehab Center on the list. Senator Jon Ossoff wasn’t shy: “It’s the largest cut to the Medicaid program in American history at a time when 70% of Georgia’s nursing home residents are covered by Medicaid.”
2. What’s Changing and Why It Matters
The new law doesn’t just cut funding; it changes the rules of the game. The bill halts enforcement of a policy from the Biden administration that would have imposed minimum staffing levels in nursing homes, suspending quality improvement. It also threatens to end dual Medicaid coverage for some Medicare beneficiaries, making it even harder for older adults to get and afford long-term care.
As UC Berkeley professor William Dow explains, “The just-signed budget law includes a series of provisions that have the potential to affect health insurance and long-term care for older adults above and beyond the $1 trillion in reductions to Medicaid.”
3. The Ripple Effect on Families and Communities
For families, closure is not merely moving a loved one. It’s facing uncertainty, possible displacement, and care gaps. “These nursing homes are already balancing on an economic tightrope, and many will be pushed out of business. The consequences for these vulnerable older Americans can’t be overstated it’s going to cause great hardship for these Americans and their families for decades to come,” Senate Finance Committee Ranking Member Ron Wyden warns in the Brown University report.
579 nursing homes across the country would shut down under the proposal, a 4% reduction in facilities on top of a 5% drop over the past decade, much of it brought about by the pandemic. And as Georgia’s elderly population is growing at a rapid pace, the timing is awful.
4. The Hidden Threats: Cuts to Staff and Services
Stopping the staffing requirement may seem like a win for facilities that have been struggling to fill positions, but it will cost. There may be compromised quality of care without mandated staffing levels. State budget pressures, in turn, may force cuts in home- and community-based services (HCBS) that allow older adults to stay at home. According to Justice in Aging, “States with budget shortfalls would be forced to look at their Medicaid programs and they’re going to cut first from what they are spending the most on and what they have available to them, that is, so-called optional benefit or optional eligibility category. These are home and community-based services, which keep millions of older adults at home where they want to age.”
5. What Families Can Do When Closures Loom
If your loved one’s facility is at risk, don’t panic but do act. The Georgia Elder Law guide suggests exploring alternative options like in-home personal care services, independent living complexes, assisted living facilities, memory care facilities, and personal care homes. Medicaid’s Community Care Services Program can help cover some of the costs for eligible individuals, with 20-30 hours of weekly in-home care. Those who have to move must seek out homes with higher occupancy and quality ratings, which are less likely to shut down.
6. Advocacy: Your Voice Matters
Advocacy is not for policy wonks it’s for every family who has a vested interest in elder care. Amber Christ of Justice in Aging urges, “We don’t have to wait to know what policies are moving forward in legislation in order to push back.” That is because all of these so-called reforms are Medicaid cuts and all of them would harm older adults. Effective strategies include calling legislators, sharing personal experience, and organizing with coalitions that defend Medicaid. Remember, public pressure has previously hindered or watered down some proposed changes in the past.
7. Increasing Home- and Community-Based Care
With facility care in doubt, increasing home- and community-based care is more important than ever. The Community Care Services Program and other Medicaid waivers can allow seniors to stay at home longer, with the help of daily tasks, transportation, and medical care. For families, it means more options and more peace of mind even in uncertain times.
Although disturbing in headlines, Georgia’s families and elder care activists are more powerful than they reckon. Being informed, prepared for transitions, and having your voice heard ensures that seniors are treated with dignity and care.
