And, it didn’t need to happen.
The cuts were for no other reason than to pay for TAX CUTS FOR MILLIONAIRES AND BILLIONAIRES
This thread was very informative.
James F. Love IV
@JamesFLoveIV
Jul 31
Short 🧵
Re: Medicaid reductions enacted in 2025 and the evidence available as of July 2026.
Impact on Nursing Homes:
Medicaid is the primary payer for more than 60% of nursing-home residents.
A 2024 HHS/ASPE study found that Medicaid payments covered, on average, only about 82% of the actual cost of caring for Medicaid residents.
For roughly 40% of nursing homes, Medicaid payments covered 80% or less of those costs.
aspe.hhs.gov/reports/assess…
That does not mean Medicaid supplies 60% of nursing-home revenue, however, because Medicare and private-pay residents generate different reimbursement amounts.
So Medicaid is financially critical even when it isn’t the majority of total revenue.
The American Health Care Association (AHCA) surveyed 363 nursing-home providers in June 2025 and asked what they would have to do if federal Medicaid funding were reduced:
77% would reduce their Medicaid census.
58% would reduce current staff.
55% would limit hiring/recruitment.
27% said they would have to close facilities.
This is a survey of operators saying that federal Medicaid reductions would force them to close facilities, not a government projection.
ahcancal.org/News-and-Commu…
How many residents could be displaced?
There were approximately 1.2 million nursing-home residents as of July 2025.
If 27% of facilities ultimately closed, a simple proportional estimate would be:
1.2 million × 27% ≈ 324,000 residents.
GAO found that 44 states cover some assisted-living services through Medicaid.
No reliable studies say “X% of assisted-living revenue comes from Medicaid.” The percentage varies a lot by facility and state.
For example, Sonida Senior Living reported that Medicaid represented 7.7% of its resident revenue in 2025, down from 10.1% in 2024.
Another large senior-living operator, Brookdale Senior Living, reported only 4.8% of resident-fee revenue from government reimbursement programs (primarily Medicaid and Medicare) in 2025.
sec.gov/Archives/edgar…
Therefore, assisted living as an industry is considerably less Medicaid-dependent than nursing homes, although Medicaid-dependent assisted-living facilities can be severely affected.
Bottom line:
Nursing homes:
Medicaid importance. Very high
Medicaid primary payer >60% of residents.
Typical Medicaid revenue share
Roughly 20–30%+ nationally, varying greatly
Facilities potentially forced to close 27% in AHCA survey.
U.S. facilities forced to close. appx. 14,742.
Potential nursing-home displacement if 27% closed ~324,000.
The really significant point is that the 27% number is not an invented political talking point. It comes from a 2025 survey of nursing-home operators themselves.
But it would be misleading to say “27% of nursing homes will close because of Medicaid cuts.” The accurate statement is “27% of surveyed nursing-home providers said Medicaid cuts would force them to close facilities.”
ahcancal.org/News-and-Commu…
The problem is particularly serious because nursing-home Medicaid isn’t simply optional insurance for many residents. Medicaid pays for nursing-facility care after Medicare’s limited skilled-nursing coverage ends, including long-term care that Medicare generally doesn’t cover.
I constructed this thread to prepare young families with parents in Nursing Homes to move their parents into their homes once the Republican enacted cuts to Medicaid become effective January 1st, 2027—in 5 months.
324,000 of them are coming home.
Thank this guy.
End 🧵
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