Medicaid is the primary payer for nursing home care. It pays directly for resident care and provides financial support that enables many residents to use their Medicare benefit as well. The budget resolution passed by the House of Representatives on February 25, 2025, which requires $880 billion in cuts in the Medicaid program over a 10-year period in order to make tax cuts enacted in 2017 permanent and to pay for border security, would be devastating for nursing facility residents, states, and nursing facilities. Medicaid is critical for nursing home residents because the United States does not have a comprehensive program to pay for long-term care services. Medicaid also helps low-income Medicare beneficiaries (called “dually eligible beneficiaries”) who live in nursing facilities through various Medicare Savings Programs. Medicaid also helps pay Medicare premiums, coinsurance, and copays. In 2021, Medicaid helped 10 million people pay their Medicare premiums and 8 million people cover their Medicare coinsurance and copays.

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