July 08, 2025

The Big Beautiful Bill Has Passed. What's It Mean To You

The Big Beautiful Bill: What It Means for Home Care Recipients in Connecticut

In July 2025, the U.S. Congress passed the "One Big Beautiful Bill Act" (OBBBA), a sweeping piece of legislation signed into law by President Donald Trump on July 4. This bill, aimed at advancing tax reforms, spending cuts, and policy priorities, includes significant changes to Medicaid that will directly impact home care recipients in Connecticut. For the nearly 950,000 Connecticut residents enrolled in the state’s Medicaid program, HUSKY, these changes could reshape access to home- and community-based services (HCBS), which many rely on for long-term care. This article breaks down the key provisions of the bill and their potential effects on Connecticut’s home care recipients.

Key Medicaid Changes in the Big Beautiful Bill

The OBBBA introduces several reforms to Medicaid, a joint federal-state program that provides health coverage to low-income individuals, including those needing home care. The most significant changes affecting home care recipients in Connecticut include:

Work Requirements: Starting no earlier than December 31, 2026, able-bodied adults aged 19 to 64 enrolled in Medicaid through the Affordable Care Act (ACA) expansion must work, volunteer, or participate in education or training for at least 80 hours per month to maintain eligibility. Exemptions apply to pregnant individuals, parents or caregivers of children 13 or younger, veterans with disabilities, and those with serious medical conditions. The Senate version of the bill extends these requirements to parents of children over 14, potentially affecting more caregivers.
Increased Eligibility Checks: Medicaid recipients will need to prove eligibility twice a year instead of once, increasing administrative burdens. Even exempt individuals must submit documentation, such as proof of disability or caregiving status, or risk losing coverage.
Funding Cuts: The bill slashes approximately $1 trillion from Medicaid over the next decade, with estimates suggesting 11.8 to 17 million Americans could lose coverage by 2034. In Connecticut, the Congressional Budget Office (CBO) projects 138,000 to 172,000 residents could lose Medicaid coverage.
Co-Payments: For Medicaid recipients with incomes above the federal poverty level (about $15,650 for an individual or $32,150 for a family of four in 2025), the bill mandates co-payments of up to $35 for most medical services, though some primary care services may be exempt in the Senate version.
Provider Tax Restrictions: The bill limits states’ ability to tax healthcare providers to fund Medicaid, potentially reducing state revenue. This could force Connecticut to cover a larger share of Medicaid costs, straining the state budget.
Home Care Funding: The bill allocates $50 million in 2026 and $100 million in 2027 for a new HCBS waiver program, but this funding is insufficient. With average per capita HCBS spending at $36,275 in 2020, the funds could cover only about 27 people per state in the first year, not accounting for inflation or overhead.

Impact on Home Care Recipients in Connecticut

Home- and community-based services (HCBS) are critical for many Connecticut residents, particularly older adults and people with disabilities, who rely on Medicaid to receive care at home rather than in nursing homes. The OBBBA’s changes could affect these recipients in several ways:

1. Risk of Losing Coverage

The new work requirements and frequent eligibility checks pose a significant risk of coverage loss, especially for those who struggle with paperwork or lack reliable access to transportation or technology to submit documentation. In Connecticut, where 73% of adult Medicaid enrollees already work part- or full-time, many may still lose coverage due to administrative errors or failure to meet reporting deadlines. For home care recipients, losing Medicaid could mean losing access to essential services like personal care aides, meal delivery, or medical equipment, potentially forcing them into institutional care or leaving them without support.

[](https://ctmirror.org/2025/07/03/big-beautiful-bill-ct-tax-relief-benefit-cuts/)[](https://www.npr.org/sections/shots-health-news/2025/07/02/nx-s1-5453870/senate-republicans-tax-bill-medicaid-health-care)

2. Increased Financial Burdens

The introduction of co-payments for medical services could strain the budgets of low-income home care recipients. For those with chronic conditions requiring frequent doctor visits or therapies, these costs could add up quickly, making it harder to afford care. Additionally, the bill blocks two Biden-era rules that would have streamlined enrollment in Medicare Savings Programs, which help low-income seniors cover Medicare premiums and cost-sharing. This could further limit financial relief for older adults in Connecticut who rely on both Medicare and Medicaid for home care.

[](https://www.americanprogress.org/article/the-truth-about-the-one-big-beautiful-bill-acts-cuts-to-medicaid-and-medicare/)[](https://www.kff.org/medicare/issue-brief/what-could-the-health-related-provisions-in-the-reconciliation-bill-mean-for-older-adults/)

3. Reduced Access to Home Care Services

The massive federal Medicaid cuts and provider tax restrictions could lead Connecticut to reduce HCBS spending, as home care is considered an optional Medicaid service. During past federal funding reductions, 40 states cut HCBS enrollment, and 47 reduced provider payment rates, trends that could repeat in Connecticut. With waitlists for HCBS already common, reduced funding may mean fewer people receive services, longer wait times, or lower reimbursement rates for home care providers, potentially driving providers out of the market and reducing care availability.

[](https://www.kff.org/medicare/issue-brief/what-could-the-health-related-provisions-in-the-reconciliation-bill-mean-for-older-adults/)[](https://ctvoices.org/2025/07/want-to-know-more-details-about-whats-in-the-one-big-beautiful-bill-act-that-the-u-s-house-of-representatives-passed/)

4. Strain on State Budget

Connecticut may need to cover a larger share of Medicaid costs due to federal cuts and provider tax limits, potentially leading to a “redesign” of the HUSKY program. State officials, including Department of Social Services Commissioner Andrea Barton Reeves, are preparing for these changes but have expressed concerns about the financial burden. If the state cannot fill the funding gap, it may reduce benefits or tighten eligibility, further limiting access to home care.

[](https://ctmirror.org/2025/05/22/trump-big-beautiful-bill-ct-lawmakers/)[](https://ctmirror.org/2025/07/03/big-beautiful-bill-house-vote-ct-delegation/)

Connecticut’s Response and Future Outlook

Connecticut officials are closely monitoring the OBBBA’s implications. Governor Ned Lamont has criticized the bill, calling it a “massive income transfer” from vulnerable residents to the wealthy, and emphasized its devastating impact on safety net programs like Medicaid. The state’s Department of Social Services is preparing for increased administrative demands and potential budget shortfalls, with waivers available to delay work requirement implementation until 2028. However, the scale of the cuts—estimated to affect 156,000 Connecticut residents, including 138,000 to 172,000 losing Medicaid—presents significant challenges.

[](https://ctvoices.org/2025/07/want-to-know-more-details-about-whats-in-the-one-big-beautiful-bill-act-that-the-u-s-house-of-representatives-passed/)[](https://ctmirror.org/2025/07/03/big-beautiful-bill-house-vote-ct-delegation/)

For home care recipients, the future is uncertain. Advocacy groups and healthcare providers, such as the American Hospital Association, warn that reduced Medicaid funding could strain hospitals and long-term care providers, with ripple effects on HCBS availability. Rural areas, where Medicaid enrollment is higher, may face particular challenges, as hospital closures or service reductions could limit access to care.

[](https://skillednursingnews.com/2025/07/house-passes-big-beautiful-bill-with-nursing-home-friendly-provisions-amid-reverberations-for-long-term-care/)[](https://www.cnbc.com/2025/07/01/how-trump-bill-medicaid-cuts-will-impact-us-health-care.html)

What Home Care Recipients Can Do

Home care recipients in Connecticut should stay informed about the OBBBA’s implementation and prepare for changes. Key steps include:

Monitor Eligibility Requirements: Keep track of new work and reporting requirements, and ensure timely submission of documentation. Contact the Connecticut Department of Social Services for assistance.
Seek Support: Nonprofit organizations and legal aid groups may offer help navigating Medicaid changes or appealing coverage denials.
Advocate: Contact state and federal lawmakers to voice concerns about Medicaid cuts and their impact on home care. Advocacy could influence how Connecticut implements the bill’s provisions.

Conclusion

The One Big Beautiful Bill Act brings unprecedented changes to Medicaid that will significantly affect home care recipients in Connecticut. With work requirements, increased eligibility checks, substantial funding cuts, and new co-payments, many residents face the risk of losing coverage or access to vital home- and community-based services. As Connecticut grapples with the financial and administrative challenges, home care recipients must prepare for potential disruptions and advocate for policies that protect their care. The full impact will unfold over the coming years, but the stakes are high for the thousands of Connecticut residents who rely on Medicaid to live independently at home.

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The Big Beautiful Bill Passed

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