One Big Beautiful Bill Act (OBBBA)

Change is on the way—and it’s BIG.

In early July, Congress passed the One Big Beautiful Bill Act (OBBBA), which President Trump signed into law. This comprehensive legislation combines tax reforms with major changes to public benefit programs like Medicaid, which many older adults, families, and people with disabilities depend on.

While many provisions won’t take effect until after December 31, 2026, now is the time to understand what’s coming—and how it may impact your family.

What Does OBBBA Mean for Medicaid?

Here are some of the most significant changes:

• More Red Tape for Medicaid Recipients
  Medicaid will now require eligibility redetermination every six months instead of once a year. That’s twice the paperwork and twice the chance for accidental loss of coverage due to mistakes or missed deadlines. This is broadly referred to in the act, so at this time, we can’t confirm if it will apply to long-term nursing home Medicaid.
• Work Requirements for Adults Ages 50–64
  Many Medicaid recipients in this age group will need to prove they work, volunteer, or are in school for at least 80 hours per month, unless they are officially exempt. Even those who are exempt due to age or disability will still need to submit proof. Medicaid recipients who have been deemed disabled by the Social Security Administration or who are over 65 will not have to meet this requirement.
• Shorter Retroactive Coverage
  Medicaid used to cover medical expenses up to 90 days before an application was filed. Now, it’s only 60 days, which puts more financial pressure on families during emergencies. Note: Medicaid benefits for certain Medicaid insurance programs (not long-term care programs) have 30-day retroactive coverage.
• Cuts to Long-Term Care Funding
  Although Georgia might not feel this as strongly as other states, funding cuts will affect nursing homes and Home and Community-Based Services (HCBS). Since Georgia’s HCBS programs are already underfunded and stretched thin, these changes could lead to even longer waitlists.

Is there any good news?

Next week, in part 2 of our 3-part blog series on this new bill, we’ll share good news for ABLE account holders and explain why some changes could make saving easier.

Hurley Elder Care Law would like to be your partner as you navigate these changes. We can help your family plan for the current and future long-term care needs. As Georgia’s premiere elder law firm, we focus on staying on top of legislative changes and ensuring our clients are prepared. Call us at 404-843-0121 to schedule your attorney meeting.

*Our thanks go out to Rothkoff Law Group for providing the initial framework of this blog.