Reformed Benefits Association

How Cuts to Medicaid and Medicare Will Affect Your Church

Written by Nikki Huttenga | Jul 31, 2025 2:15:58 PM

In January 2027, nearly 18 million people will be in danger of losing government-funded health care coverage through Medicaid and Medicare. This is because the One Big Beautiful Bill changes the rules for government-funded health care coverage. And it’s very likely to impact members of your church. 

It is easy to understand how this may cause additional stress and anxiety to your congregation. In times of crisis, people turn to their church leadership for both spiritual and earthly support and direction. Will you be ready?

However, many church leaders aren't given the necessary information needed to be prepared to answer questions about health insurance. But if you continue reading, this guide will provide you with all the details on what to expect and how you can be a resource for those in crisis.

Who will be impacted the most by cuts to Medicaid and Medicare?

Not every congregation will experience this in the same way. The new law is designed to address specific groups. The following people may feel the effect more than others.

Legal immigrants are hit hard. Refugees, asylum seekers, DACA recipients, and work visa holders will lose their ACA marketplace subsidies. On top of that, health insurance premiums may become unaffordable for many.  

Low-income families on Medicaid will now have work requirements and shorter coverage periods. You can expect more people to fall through the cracks as they become ineligible for any government health insurance programs. 

These work requirements will be particularly hard on families with young children. Many will be faced with the shock of having to find childcare and working multiple jobs that may keep them from spending valuable time with their families. 

The Elderly, who don’t have citizenship but live legally in the U.S., will also be losing Medicare eligibility. 

If any of these groups make up a portion of your congregation, you’re likely to encounter additional stress and crisis that stems from losing access to health care. 

What does this mean for my ministry?

Cuts to Medicaid and Medicare, along with changes to Marketplace plans, will affect churches in significant ways. The stress of losing health care can cause depression, affect family life, impact work performance, and decrease mental health in general. 

Here are 4 ways you could see the impact of this new legislation:

  1. You may lose health care eligibility if you have Marketplace coverage. Rising costs may make your plan unaffordable without early planning.  
  2. You may find premiums for your church will go up. Reduced federal payments to hospitals from Medicaid and Medicare will result in rising prices for procedures. These costs get passed on to every insurance company, which then raises premiums for all of its customers. 
  3. More pastoral care requests may come from your members. They may need help figuring out what to do about healthcare coverage for themselves or loved ones. You'll likely see a rise in crisis counseling and assistance requests as church member insurance concerns multiply.
  4. You might be surprised by who is affected. Bronze-level marketplace plans now require more paperwork and stricter qualification requirements. Many people will lose coverage simply because they didn't complete the paperwork correctly or missed a deadline. Be ready to counsel people who thought they were going to be okay. 

The Essential Preparation Strategy

The new regulations take effect in 2027, but you can begin to prepare now. Here's your roadmap for handling the challenges that lie ahead.

Step 1: Assess Your Risk (Do This Now)

Look at your congregation with fresh eyes. How many immigrant families do you serve? Do you have lower-income families in your congregation who might be using Medicaid? 

And what about the older population of your church who have lived in your community for years, but don’t have American citizenship? Don't be intrusive, but start paying attention.

Check your church resources, too. How much is in your benevolence fund? Do you have healthcare volunteers? Do you partner with local clinics or nonprofits that can help? It’s important to know what you're working with before the questions start flooding in.

Step 2: Educate Yourself and Your Congregation (Before 2027)

Connect with your insurance partner. See if they offer any advice on how to help your congregation navigate these changes. They should have resources and expertise to help church leaders understand what's coming.

As you learn about alternative coverage options, create a simple resource sheet with all the information to distribute to your congregation. You can also start building relationships with community health centers now.

Training volunteers to help with paperwork and applications also becomes important at this stage. When the new changes hit, your church could give back by acting as a service center for your congregation and the surrounding community. 

Step 3: Prepare for Increased Need

You may want to consider expanding your benevolence fund planning. The need for help with health care is coming, so now is the time to plan for it.

One way you can do this is by developing emergency medical assistance protocols. How will you help when someone shows up at your door with a medical crisis and no insurance?

Planning for more pastoral counseling time also becomes essential. Knowledge and connections with local services will allow you to help parishioners with their specific roadblocks. Take time out of your calendar space now for the increased care needs you'll face in the future.

You Might Be Thinking…

2027 seems a long way off, and the changes seem far into the future. But don’t be tricked by these assumptions: 
 
“I don’t have to worry about this right now, I have a few years.”
The cuts to Medicaid and Medicare will start impacting families in less than two years. Early preparation prevents crisis scrambling and makes your life simpler. 

"My church won't be affected."
Even affluent churches often have members on Medicaid, you might not know about.

"I don't know if I can make time for this on top of all of my other responsibilities at the church." 
Your health insurance partner should provide the expertise so you don't have to become a healthcare expert yourself. Find out if they offer comprehensive pastoral resources for health insurance situations.

"This is too complicated.” 
You can focus on pastoral care, not policy details. You're not becoming an insurance agent.

Navigate the Changes Together

You don’t have to navigate the cuts to Medicaid and Medicare alone. Begin assessing your congregation's needs soon, and remember, if your insurance provider can’t help you, expert help is available when you need it most.

The information contained in this blog is for educational purposes only.