New Issue Brief: H.R. 1 and the Changing Landscape of Care for Older Adults

H.R. 1, or the One Big Beautiful Bill Act, signed into law in July 2025, introduced significant changes to Medicaid, Medicare, and related social services that many older adults rely on to access health care and remain living at home or in a community-based setting. H.R. 1’s changes include tightening Medicaid and the Supplemental Nutrition Assistance Program eligibility policies and shifting provider payment dynamics in Medicare. These changes raise important considerations for access, affordability, and stability for older adults, particularly those with low incomes or complex care needs. Furthermore, while H.R 1 did not directly reduce funding for home and community-based services (HCBS), the law is likely to have significant downstream effects on HCBS access as states face growing budgetary pressures.

To help policymakers and other stakeholders understand how H.R. 1 affects how older adults’ health care is financed and administered, West Health Policy Center partnered with Aurrera Health Group to develop a new issue brief, How H.R.1 Reshapes Healthcare for Older Adults. This brief outlines H.R. 1’s key Medicaid and Medicare provisions affecting the continuum of health care services for older adults. Understanding the law’s implications on health care and supportive services for older adults can enable policymakers and stakeholders to pursue opportunities to mitigate potential risks to older adults’ health care access and outcomes.

While many of the bill’s provisions have and will continue to roll out over the coming years, the decisions and policies states make, through thoughtful planning, stakeholder engagement, and prioritization of aging services, will shape whether older adults face increased barriers or benefit from more coordinated, sustainable systems of care. For more information on how we can help your organization navigate federal policy changes, please contact Kristal Vardaman.

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Authors

Mallika Mahalingam [Deputy Director]

Kristal Vardaman [Managing Principal]