As more than 700 long term care advocates descend on Capitol Hill this week, a new survey from the American Health Care Association (AHCA) finds that an overwhelming majority of nursing home providers are deeply concerned about potential Medicaid reductions. More than one-quarter of respondents report that reductions would force them to close.
The survey, conducted by AHCA in May 2025 of 363 nursing home providers, reflects growing concerns by long term care professionals across the country as Congress debates a budget reconciliation package that includes federal spending reductions to Medicaid. Of the respondents, 52 percent identified as independent, single-facility operators and 60 percent are in rural communities.
“This report confirms what we’ve been hearing for months: that any reductions to Medicaid would be devastating for seniors, caregivers, and communities,” said Clif Porter, President and CEO of AHCA. “Without reliable Medicaid resources and programs like provider taxes, nursing homes would face impossible decisions, like having to reduce staff or close their doors. This is why our members are in DC this week reminding lawmakers that Medicaid knows no politics: this program impacts people in every community in every state. We must do right by vulnerable seniors and protect their long term care.”
Highlights from the survey include:
Medicaid continues to be chronically underfunded:
- Nearly two-thirds of nursing home providers report Medicaid reimbursement as less than 80 percent of the actual cost of care.
- 11 percent of respondents reported that they’re receiving less than 50 percent of the actual cost of care.
An overwhelming majority of nursing home providers (92 percent) are concerned about potential reductions to Medicaid.
- Most are extremely concerned (79 percent) or moderately concerned (13 percent).
- More than 8 in 10 providers say any reduction to or elimination of provider taxes would have a severe impact on their facilities.
The impacts of Medicaid reductions are disparate and significant, with seniors and staff bearing the brunt of any cuts. If federal funding for Medicaid is reduced:
- 77 percent of providers say they would have to defer modernization efforts, like capital improvement projects or investing in new technology.
- 58 percent would be forced to reduce their current staff, and 44 percent would limit new hires and recruitment efforts, a significant blow to the slow but steady recovery of the long term care workforce.
Most concerning, reduced access to care is a reality for many seniors if Medicaid funding is reduced.
- 55 percent of nursing home providers say they would have to reduce their Medicaid census, meaning fewer available beds for low-income seniors and individuals with disabilities.
- 27 percent say they would be forced to close their facilities.
“The consequences are undeniable,” continued Porter. “Restricting provider taxes is restricting resources to seniors and their caregivers. There are better ways to find government efficiencies that do not jeopardize access to care. We urge Congress to restore the promise made to our most vulnerable.”
The release of the survey coincides with AHCA and the National Center for Assisted Living (AHCA/NCAL)’s annual Congressional Briefing, a two-day event in Washington, D.C. that offers long term and post-acute care professionals the opportunity to engage directly with lawmakers and advocate for policies that support the profession. With over 700 registered attendees, the fly-in is AHCA/NCAL’s largest ever. In addition to their meetings on the Hill, attendees will hear from keynote speaker Howard Kurtz, host of “MediaBuzz” on Fox News.
Read the full results of the survey HERE.