Reactions to the recently passed “One Big Beautiful Bill” (BBB) vary widely. For senior care providers, some provisions appear helpful, others introduce additional administrative burdens, and still others carry consequences that remain uncertain.
What is clear, however, is that this new law will both directly and indirectly affect the operations and strategies of Baptist Homes & Healthcare Ministries. In many ways, how Missouri lawmakers respond to the federal Budget Reconciliation law over the next two years will shape our mission even more than the federal provisions themselves.
What We Know
The BBB reduces federal Medicaid spending by more than $1 trillion over the next decade. According to the Congressional Budget Office, as many as 16 million Americans may lose Medicaid benefits—including approximately 170,000 Missourians. Most of those affected are under 65 and are individuals with limited or no disabilities, according to published reports.
Key changes in the current reading of the law include increasing the Medicaid requalification periods from annual to biannual redeterminations and reducing retroactive payments for new Medicaid eligibility from months to two months. These changes will increase administrative loads by requiring biannual verification of Medicaid qualifications and will reduce reimbursement for most new Medicaid residents by one month, which places an additional burden on families and facilities.
The majority of those at risk of Medicaid cuts live in the “Medicaid expansion states.” In 41 states, including Missouri, voters approved expanded eligibility beyond federal guidelines. As a result, Missouri is projected to receive $21.1 billion less in federal funding over the next ten years.
It is important to note that residents of assisted living homes and skilled care facilities who are 65 and older are not the target of these reductions and are generally exempt from these cuts.
What This Means for Baptist Homes
Despite headlines warning that “1,600 Nursing Homes Will Close Without Financial Support from Congress,” widespread closures are unlikely. Even so, Baptist Homes will face increased administrative costs and new layers of complexity in managing care, compliance, and financial planning. The new budget also shields skilled care providers such as Baptist Homes from a proposed increase in RN coverage, which is helpful given the nursing shortage across Missouri.
A Steadfast Hope
Psalm 112:6–7 reminds us: “The righteous will never be shaken; he will be remembered forever. He is not afraid of bad news; his heart is firm, trusting in the Lord.” As we navigate these changes, we do so with confidence that the Lord will continue to provide for His people and sustain the mission of Baptist Homes.
Together in His service,
Rodney Harrison
