No, the new federal cuts do not remove Medicaid hospice coverage. Hospice care — support focused on comfort at the end of life — remains covered where states now cover it. According to 90.5 WESA in its Pennsylvania Medicaid analysis, the new law cuts Medicaid spending by more than $900 billion over 10 years. The risk for hospice is therefore loss of Medicaid eligibility, not loss of the benefit.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Official resources:
- Check eligibility on CMS’s official study page — Use this page to check the study’s participation requirements.
- Register through CMS’s official page — Use this page to review requirements and register directly.
Table of Contents
- What did the law change for hospice?
- Who must document work to keep Medicaid?
- Will hospice visits cost more?
- What should dementia families do now?
What did the law change for hospice?
Hospice leaders told Hospice News the law did not change Medicare hospice payment or remove the Medicare hospice benefit. The effect is indirect, through Medicaid eligibility and funding pressure. CMS separately raised Medicare hospice payments by 2.6%, about $750 million, for FY 2026 starting Oct.
1, 2025. The aggregate cap rose to $35,361.44, CMS said. Medicaid hospice itself is an optional state benefit under federal law, not mandatory. LegalClarity, citing federal law and KFF, notes no state now excludes it, with 46 states confirming coverage.
Who must document work to keep Medicaid?
Starting Jan. 1, 2027, certain Medicaid expansion adults ages 19-64 must document 80 hours per month of activity. Qualifying activity includes work, school, work program or community service, according to CMS in its nationwide work-requirement framework.
Hospice and palliative-care patients are not explicitly listed as exempt, Hospice News reported. They must qualify under general exclusions such as medically frail, serious medical condition or caregiver status. For dementia families, eligibility often turns on paperwork rather than need:.
- Check whether coverage is Medicaid expansion or another category
- Ask the clinic to document frailty, serious condition or caregiver role
- Keep monthly proof of hours or exclusion in one folder
Will hospice visits cost more?
Starting Oct. 1, 2028, states must charge expansion adults with incomes 100-138% of poverty up to $35 per service, capped at 5% of income.
Hospice patients and hospice services are expressly excluded, according to South Dakota DSS in its advisory committee handouts. For dementia families, that means hospice care itself should not carry that fee. Other health visits in that income group could face charges.
What should dementia families do now?
People who lose Medicaid can still keep Medicare hospice coverage, especially dual-eligibles. They may still lose help with supportive health and nonmedical resources, CMS said.
CMS allows a hold-harmless period through June 30, 2027 without disenrollment solely for work-rule failure, according to CMS in its hold-harmless announcement. Use that time to secure the file: Bring that proof to every renewal and ask the hospice social worker to note frailty in the file.
- Confirm whether the person has both Medicare and Medicaid
- Ask the hospice team to update records for frailty exclusion
- Calendar renewal dates and keep proof together
