Starting January 1, 2028, District of Columbia residents who need Medicaid to pay for long-term care, such as a nursing home, will have to have home equity of $1 million or less. The limit comes from the federal law signed on July 4, 2025, and D.C.’s Department of Health Care Finance lists it among the changes coming to the District’s program. For some D.C. homeowners, it is a cut from a higher limit.
What the $1 million line means for D.C. homeowners
The department’s page says that for people who need long-term care, a home’s value must be $1 million or less to qualify for D.C. Medicaid under the new rules. Justice in Aging, a legal advocacy group for older adults, describes the federal test as equity: the property’s value minus any money owed on it.
The group says twelve states and D.C. use the higher federal limit of $1,130,000 in 2026. Under the new law, those jurisdictions must drop to $1 million in 2028. The basic federal limit is $752,000 this year, and the group estimates it could reach $1 million in seven to ten years.
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DHCF does not say how many D.C. residents the limit would affect, or what the District’s current cap is. Justice in Aging’s $1,130,000 figure applies to D.C. and twelve states, so a D.C. homeowner with equity between $1 million and $1.13 million would be covered today and ineligible after the change.
Who is exempt, and what stays outside the cap
Justice in Aging reports the limit does not apply if a spouse, a child under 21, or a blind or disabled child of any age lives in the home. Homes on land zoned for agricultural use follow the older rules instead.
Federal law also directs CMS to set up a process for waiving the limit in cases of demonstrated hardship. The group says CMS and most states have not built those processes yet. D.C. has not described one on its page.
States may apply different limits to different areas of the state, but they must still honor the exceptions for a spouse, a minor or disabled child, and undue hardship. Whether D.C., a single jurisdiction, will use any such flexibility has not been addressed on the department’s page.
Nothing in the provision stops a person from using a reverse mortgage or home equity loan to reduce equity, according to Justice in Aging. The group adds that none of these exceptions apply to Medicaid estate recovery, the rule that lets a state seek repayment from an estate after death.
The other dates on the District’s calendar
The home-equity limit is the last of several changes DHCF lists under the 2025 law. On October 1, 2026, some noncitizens lose eligibility for DC Medicaid. The District says refugees and asylees without green cards generally lose it that day, while green card holders face a five-year wait unless an exception applies.
On January 1, 2027, most adults ages 19 to 64 without dependent children must complete at least 80 hours a month of work, training, volunteering or similar activity to keep coverage. They must also renew every six months instead of once a year. DHCF says more information is coming and its page lists no exemptions.
Also on January 1, 2027, Medicaid can pay for bills from only one month before an application for adults without children. Everyone else, including seniors, can still have bills from up to two months before applying paid.
DHCF describes the work rule and six-month renewals as applying to most adults 19 to 64 without dependent children. Its page gives no separate rules for older adults needing long-term care, so the home-equity limit is the change aimed at that group.
The October 1 change has a safety valve. DHCF says Emergency Medicaid remains available for emergency care, including labor and delivery, for people who do not qualify for full coverage because of immigration status. Children and pregnant people lawfully residing in the District are not subject to the five-year wait, and pregnancy coverage lasts 12 months after the pregnancy ends.
What D.C. members are told to do now
DHCF tells members to update their address and contact information, check their mail for coverage letters and respond right away at renewal. Members can update details at districtdirect.dc.gov. District Direct’s call center is 202-727-5355, and DHCF’s main line is (202) 442-5988, with TTY at 711.
DHCF also holds eligibility meetings for residents. Evening sessions run on the last Friday of each month at 6:30 p.m., and the next two are November 20 and December 18. Afternoon sessions run every other Wednesday at 2:30 p.m., including November 4 and 18.
The unresolved piece is how D.C. will measure equity for applicants. DHCF’s page describes a home’s value, while the federal test is value minus debt. Households near the line will want that settled before the 2028 start, and DHCF has not said when it will publish the details or how it will value a home for the test.
Will home equity block nursing-home Medicaid in D.C. in 2028?
A home with equity near the $1 million line, or a coverage letter that goes unanswered in 2027, can cost a D.C. household its Medicaid before the 2028 cap even starts. The District’s own page tells members to watch the mail and respond right away at renewal.
The SNAP & Medicaid Renewal Organizer is built for keeping those dates. It has a renewal and reporting calendar, a renewal document checklist, the 90-day window after coverage is dropped, and state packs for all 50 states and D.C.
Get the Medicaid renewal calendar and D.C. pack →
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This article was produced with AI assistance and edited for accuracy against the sources linked above.
