NJ Familycare: New Jersey’s Medicaid/Chip Program for 2025–2026 (And Beyond)

It is well documented that Medicaid is an expensive program and while government officials deal with the politics of the situation, there are some upcoming changes and proposed policy shifts that will affect attorneys and elder law planners in New Jersey. Some are already in effect. Others are pending.

Congress is considering major reductions to federal Medicaid spending. Advocacy groups warn that many older adults and people with disabilities could be affected by funding cuts. While changes might not yet be final, attorneys should build contingency planning into elder law and long-term care advice, for example, alternative funding strategies or earlier eligibility/benefit review.

Factors to consider include

Eligibility & budgeting: With potential tighter rules, six monthly redeterminations, work requirements, and immigrant eligibility shifts, attorneys should review their clients’ income/asset status more frequently and ensure documentation is in order.

Home and community-based services (HCBS): Funding uncertainty means potential reductions in service availability (e.g., home health, assisted living subsidies). In advising their clients, attorneys should include contingency planning: private pay, insurance, or alternate support.

Coordination with providers: Given state budget stress, provider reimbursement may change, causing service providers (home care, nursing homes) to change contracts, staffing, or costs. Attorneys should warn clients about provider risk.

Immigration and mixed status households: If non-citizen adult household members risk losing coverage, alternative planning is critical (private insurance, community resources, state only funded programs).

Documentation for younger adults on Medicaid: For clients (or children of clients) who are working age adults on Medicaid, the potential work/volunteer requirement means tracking hours, collecting proof, and verifying exempt status (disability, caregiving, student) early.

Guardianship/Trust oversight: As client health declines, effective care planning (including with a care manager) becomes more important; service changes may affect monitoring obligations of fiduciaries/trustees/guardians.

Estate planning tweaks: The risk of earlier or more aggressive eligibility regression means quicker transitions, spend down strategies, and perhaps earlier use of trusts or asset protection vehicles.

Experienced Attorneys in Medicaid

Medicaid is complicated and before you act, you should contact an experienced attorney. The attorneys at Weiss & Tom, LLC can assist you in developing a viable plan going forward considering the changes that may be coming in Medicaid.