LeadingAge PA sent a letter to Governor Josh Shapiro on January 20, 2026, requesting a floor of 0.84 for the Budget Adjustment Factor (BAF). Initially designed as a temporary budget tool, the BAF has transformed into a structural mechanism that consistently keeps Medicaid reimbursement rates for nursing homes below sustainable levels. According to current cost reports and case-mix data, a 0.84 BAF floor would require approximately $274 million (annualized) in state funding and would help restore some predictability to the rate-setting process to ensure that nursing homes do not face further reductions that could threaten access to care. 

We need your help urging the Governor to support our proposal, which is a necessary step to avoid further erosion of the long-term care infrastructure that thousands of Pennsylvanians rely on. 

IMPORTANT: Under the “Message Body” field of the “Compose Your Message” box on this page, please insert specific examples revealing the need for this investment to reduce the existing Medicaid shortfall and provide much-needed predictability and relief. 

• What does the nursing care you receive mean to you?
• An example of how a nursing professional has positively impacted your life.
• What concerns do you have about the future of your nursing care?
• If you are not currently receiving nursing home care, why is preserving access to this service setting important to you?

If you have any questions, please email govaffairs@leadingagepa.org. Thank you for speaking up to protect and strengthen aging services in PA!