Issue #3 · September 22, 2026
New Medicaid restrictions take effect soon. Here's what families need to know.
There's a lot moving in healthcare policy right now, and some of it will land squarely on families trying to arrange care for aging loved ones. The biggest development is the new Medicaid eligibility restrictions for lawfully present immigrants, which are set to take effect on October 1, 2026. That's barely a week away. Under the 2025 reconciliation law, many immigrants who currently qualify for Medicaid coverage will lose that eligibility, and CMS guidance on how states should implement the changes is still being sorted out. If your family includes a parent or grandparent who is a lawfully present immigrant receiving Medicaid, this is the time to review their coverage status and talk to their caseworker.
On another front, the conversation about artificial intelligence in healthcare keeps getting louder. Industry leaders are openly debating whether AI needs more government regulation or whether the real risk is something different entirely: too much regulation stifling tools that could actually help patients and providers. For families, this matters because AI is already showing up in care coordination, clinical decision support, and even hospice referral systems. The question of who oversees these tools and how they're held accountable is not abstract. It affects the quality and reliability of the care recommendations your family receives.
Meanwhile, a report on individuals with limited English proficiency highlights a problem many families already know too well. Roughly 28.5 million people in the U.S. over the age of five have limited English proficiency, and they are far more likely to experience gaps in health coverage and worse health outcomes. For elderly family members who primarily speak a language other than English, getting accurate information about hospice options, home health benefits, and care rights can feel nearly impossible. Language barriers don't just cause confusion; they cause people to miss out on care they've earned.
If your loved one's care is covered through a Medicaid managed care plan, pay close attention over the next few months. The same reconciliation law that's changing immigrant eligibility is also creating serious uncertainty in how Medicaid managed care rates are set. When reimbursement rates become unpredictable, managed care organizations sometimes exit markets altogether. That means families could find themselves scrambling when the plan that covers their parent's home health aide or hospice benefit suddenly pulls out of their state or region.
This isn't a hypothetical. Plan exits have happened before, and the current rate setting environment makes them more likely heading into 2027. If you get a notice from your loved one's Medicaid managed care plan about changes to their network, coverage area, or provider availability, do not set it aside. Read it carefully and call the plan to ask what it means for continuity of care. If you need help understanding your options, reach out to us. That's exactly what we're here for.
Let's talk about something that trips up a lot of families: the difference between what Medicaid covers for home health care and what it covers for hospice, especially for people who might be losing Medicaid eligibility soon. Under traditional Medicaid, home health services like skilled nursing visits, physical therapy, and personal care aides are covered, but the scope varies significantly by state. Hospice under Medicaid generally mirrors the Medicare hospice benefit, meaning it covers comfort care, medications related to the terminal diagnosis, medical equipment, and support services for the family. If your loved one currently receives either of these benefits through Medicaid and their eligibility is about to change, you need to understand exactly which services will be affected.
Here's something worth knowing: even if Medicaid eligibility is lost, Medicare hospice benefits remain available to anyone who qualifies for Medicare, regardless of immigration status considerations that affect Medicaid. Medicare covers hospice care at essentially no cost to the patient, with only small copays for outpatient drugs (no more than $5 per prescription) and a 5% coinsurance for inpatient respite care. So if your family member is Medicare eligible and has a terminal prognosis, the hospice benefit is still there. The key is making sure you're not leaving money on the table by assuming that losing one form of coverage means losing everything.
We know that policy changes can feel overwhelming, especially when you're already carrying the emotional weight of caring for someone you love. That's why we keep this newsletter honest and practical, because you deserve clear information, not jargon. Best Hospice and Home Health is completely free for families, and our only goal is to connect you with verified providers who can help. If you know someone who is worried about a parent's care coverage or just starting to explore hospice and home health options, please share this newsletter with them. Nobody should have to figure this out alone.