Long Term Care Planning: How the One Big Beautiful Bill Act (OBBBA) Will Change Medicaid Eligibility in Florida in 2028
The One Big Beautiful Bill Act (OBBBA) was signed into law by President Donald Trump in July of 2025. It is comprehensive legislation that has a wide range of different provisions. One big, lesser known provision will have big implications for long term care planning; and specifically Medicaid eligibility. However, it will not take effect until January 1st, 2028. In this article, our St. Petersburg Medicaid planning attorney provides an overview of the key things that Florida families should know about the OBBBA.
Why the Changes Matter: The OBBBA Introduces a New Floor for the Federal Asset Test
The OBBBA creates a uniform federal floor for Medicaid long term care eligibility that will begin January 1st, 2028. Why will that change matter for families in Florida? The short is that while Florida already operates under federal guidelines, it retains flexibility in how it defines countable assets and exemptions. Indeed, Florida has some of the most generous exemptions in the entire country. The OBBBA narrows that flexibility. All states will be required to apply a standardized asset framework for long term care Medicaid. That reduces the state-by-state ability to exclude certain assets through specific rules. For Florida families, this means fewer planning options that rely on asset characterization rather than true spend down. Liquid assets, investment accounts, and certain trusts that currently fall into gray areas are more likely to count. There are big implications for long-term care planning.
Lookback Rules and Penalty Periods Will Tighten
The OBBBA also modifies federal lookback enforcement. While the five year lookback period remains in place, the new law will require more stricter penalty calculations and it will also limit state discretion in reducing penalty periods. That matters for families in St. Petersburg and elsewhere in Pinellas County because Florida Medicaid currently applies penalties based on a divisor tied to average nursing home costs. Under the new law, that divisor will move closer to actual regional costs. Once again, there will be less flexibility.
Florida’s Homestead Exemption Will Remain Critical but Narrower in Practice
Florida’s constitutional homestead exemption will remain intact after the OBBBA takes effect. A primary residence will still be exempt from countable assets for Medicaid eligibility purposes, subject to existing equity caps. However, the practical protection homestead provides may narrow. The OBBBA increases scrutiny of transactions tied to exempt assets. Converting non-exempt assets into homestead shortly before applying for Medicaid may trigger enhanced review under transfer and intent rules. Proactive planning is a must. A top attorney can help.
Call Our St. Petersburg Long Term Care Planning Attorney Today
At Fisher & Wilsey, P.A., our St. Petersburg long term care planning attorney has the experience that you can trust. A proactive plan can help to make the difference. If you have any questions about the OBBBA and Medicaid strategies, please do not hesitate to contact us today. From our St. Petersburg office, we handle long-term care planning issues in Pinellas County and all across the region.
Source:
congress.gov/bill/119th-congress/house-bill/1/text
