One million dollars is the ceiling Congress has placed on the home equity a state may protect when it decides whether Medicaid will pay for a person’s nursing facility care. The figure takes hold on January 1, 2028. Above it, equity in an ordinary house stops being something any state has the discretion to shelter, no matter how far local property values have run.
How $500,000 in the statute became $752,000 in 2026
The underlying rule is decades old and turns on equity rather than eligibility for Medicaid generally. Section 1917(f)(1) of the Social Security Act bars a state from covering nursing facility services or other long-term care services for someone whose equity interest in their home exceeds a set dollar limit. The statute names a minimum of $500,000 and a maximum of $750,000, and a state may elect any figure inside that band.
Those two numbers have not been the operative ones for a long time. Since 2011 both have been adjusted year to year by the increase in the consumer price index for all urban consumers. For 2026, a CMCS informational bulletin issued December 9, 2025 set the minimum at $752,000 and the maximum at $1,130,000, effective January 1, 2026, on a stated CPI increase of 3.0 percent for the year.
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What section 71108 does to the top of that band
Section 71108 of Public Law 119-21 rewrites the indexing machinery rather than the base figure. The current text of 42 U.S.C. 1396p carries the amendment note, applicable beginning January 1, 2028, adding a sentence that deems any adjusted dollar amount above $1,000,000 to be equal to $1,000,000, and a new clause allowing a state to elect an amount for a non-agricultural home that exceeds the minimum but does not exceed $1,000,000.
The practical effect is that the band stops widening at the top and keeps closing from the bottom. CMS has told states the minimum limit will continue to rise with CPI-U increases until it too reaches $1,000,000, at which point there is no band left to elect within. States that currently sit at the higher figure, $1,130,000 in 2026, would have to bring their non-agricultural limit down. The same section also amends the Act to prohibit states from using a home equity valuation methodology that effectively raises the limits above what the statute mandates, closing the obvious workaround. Unlike the community engagement provisions of the same law, this one applies to all states, the District of Columbia, and the territories.
The carve-out for a home on land zoned for agricultural use
One category of house is deliberately left on the old track. The $1,000,000 ceiling does not apply to a home located on a lot zoned for agricultural use, and CMS’s summary of the law’s Medicaid provisions explains that states may elect a maximum limit for those homes that continues to climb with CPI-U increases in place of the flat cap.
After 2028, in other words, a farmhouse and a suburban house holding identical equity can be treated differently by the same state program. Both share the same rising minimum limit; only the agricultural home keeps access to a maximum above $1,000,000.
The relatives whose presence sets the limit aside entirely
The equity test does not apply at all when certain people are lawfully residing in the home. The statute lists the individual’s spouse, a child under age 21, and a child who is blind or has a disability. Those exceptions survive the 2028 amendment untouched, which matters most for a married couple where one spouse enters a nursing facility and the other stays in the house.
Two other provisions in the same subsection remain available. Nothing in the law prevents an individual from using a reverse mortgage or a home equity loan to reduce total equity interest in the home, and the Secretary is required to maintain a process for waiving the limit in cases of demonstrated hardship.
Equity is not the sale price, and CMS points states to SSI rules
The test measures equity interest, meaning what is left after what is owed on the property, not the number a real estate listing would carry. A house appraised well above the limit with a substantial mortgage still outstanding can sit under it. For how that value is actually determined, CMS has instructed states to follow the basic policies of the Supplemental Security Income program, citing its own State Medicaid Director letter on the subject.
It is also worth being precise about what the limit blocks. The statute disqualifies an individual from medical assistance with respect to nursing facility services or other long-term care services. It is a long-term care rule, and a household reading its state’s number should be reading it against the cost of a nursing home rather than against ordinary Medicaid coverage. The figures that govern in the meantime remain the ones in the December 9, 2025 bulletin, which states must apply for changes effective January 1, 2026.
This article was produced with AI assistance and reviewed by a human editor. Figures are linked to their primary sources; where a claim could not be verified from the public record, we say so.
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