“Big, beautiful bill” cuts to Medicaid could be devastating for nursing home residents

July 1, 2025
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Jason Barrett visits his 94-year-old grandmother, Ruth Raney, at the Martinsburg Healthcare Center in West Virginia as often as he can. Medicaid will soon be covering the cost of Raney’s care, putting her among the 77% of West Virginia nursing home residents — and 63% of nursing home residents nationwide — who rely on the program.

But that funding could be cut by $930 billion over the next 10 years by the massive spending bill approved by the Senate on Tuesday. The concern is those cuts could lead to reduced staffing and tightened eligibility requirements in long-term care facilities nationwide. 

Nancy Mason, who runs the nursing home where Raney lives, said she’s concerned about the impact on their operational costs. 

“It helps to meet our operational expenses, everything from pharmaceuticals to food to utilities to recruitment of staff, and, you know, all of our wages,” Mason said.

And Barrett isn’t just a concerned grandson, he’s a Republican state Senator in West Virginia.

“We have to get to a place where we’re balancing our budget again. I don’t think we do that on the backs of nursing home residents,” he said.

The Senate version of the spending bill now moves back to the House after a 51-50 vote. The previous House version of the bill had called for slightly smaller cuts to Medicaid, nearly $800 billion over 10 years. Following its passage in the Senate, House Speaker Mike Johnson said the upper chamber “went a little further than many of us would have preferred, but we have the product now,” leaving it unclear how much the House would try to further amend the bill before a final vote.

“We have members across the conference who have concerns about various provisions of the bill,” Johnson said, adding, “We’re going to try to answer all those concerns and get this bill delivered on time, as we expected and hoped from the very beginning. So, lot of work ahead, but that’s the job, so we’ll get it done.”

Asked if West Virginia would be able to fill in the gaps created by the spending bill, Barrett wasn’t optimistic.

“A complete backfill of cuts to Medicaid would be very crippling to our state budget,” he said.

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