Understanding the Impact of Cuts to Elder Services

In recent months, proposed federal budget changes have included reductions in funding to programs that support older adults, including Medicaid and the Administration for Community Living, ACL. These proposals raise important questions about the future of elder care  in the United States, especially for individuals living in long-term care facilities or relying on community-based support.

What is Being Proposed

Medicaid Adjustments. Federal budget plans under review include significant cost reductions to Medicaid over the coming years. Since Medicaid is the primary public payer for long-term care in the U.S., these adjustments could affect the availability and scope of services offered in nursing homes, long-term care, and home-based care settings.

Reorganization of the Administration for Community Living. There are also discussions around restructuring or redistributing the functions of the ACL, an agency that supports older adults and individuals with disabilities in maintaining independence. These changes could shift programs to other parts of the Department of Health and Human Services, potentially impacting how services are coordinated and delivered.

Why This Matters

Medicaid currently supports a substantial portion of older adults living in long-term care settings. Without access to these funds, many individuals— especially those with limited income, may face reduced service options or disruptions in care. This includes not only medical and personal care services, but also programs that promote mental health, social connection, and overall quality of life.

Similarly, changes to the ACL could affect how ageing-related services are planned and implemented. Agencies like ACL provide expertise and continuity in addressing the specific needs of older adults. Redistributing these responsibilities may lead to knowledge gaps or inconsistencies in service delivery, particularly during a time when the U.S. population is aging rapidly.

A Community-Based Perspective

At United We Age, our nonprofit organization is powered by volunteers who provide critical support— especially emotional support, to residents in long-term care and assisted living facilities. We see firsthand how deeply these individuals rely on the systems in place, especially Medicaid. Many of them are in these facilities because of Medicaid. Any reduction in Medicaid funding could significantly limit their options for safe and appropriate care.

Looking Ahead

The U.S. population over 65 is projected to nearly double by 2060. As policymakers consider changes to funding and service structures, it’s important to evaluate how these decisions align with the needs of a growing aging population. Access to affordable, consistent, and person-centered care will remain a key factor in ensuring older adults can live with security and dignity in their later years.

These are complex issues with long-term implications. Ongoing analysis and dialogue will be important as decisions move forward. All stakeholders— families, caregivers, providers, and policymakers— have a role to play in shaping a sustainable and responsive system for aging services.

In the end, this isn’t only about the older adults who need care today— it’s about all of us. With time, each of us may come to rely on the same support systems we’re shaping now. Taking care to strengthen them is one way we look out for each other, now and in the years to come.

David Lereah,

President, United We Age