Attack on Medicaid
The Center for Medicare Advocacy strongly opposes the recent tax legislation that proposes devastating cuts to the Medicaid program and harms millions of Medicaid and Medicare beneficiaries. The latest estimates from the non-partisan, independent Congressional Budget Office (CBO) show that the legislation will terminate health insurance for 13.7 million people. Initial estimates find the tax bill could include roughly $1 trillion in health care cuts. These cuts will harm older adults and people with disabilities who rely on Medicaid to receive long-term care supports and services (LTSS), including in nursing homes and for those receiving LTSS at home. When federal Medicaid funding is cut, states will have no choice but to make up the difference, or cut Medicaid budgets through changes to eligibility requirements, reductions in payments to providers, or by making Medicaid renewals more difficult, resulting in millions of eligible individuals being kicked off Medicaid.
Attack on Medicare
In addition to these cuts to Medicaid that threaten people who also have Medicare, there are provisions that directly target Medicare beneficiaries. As outlined in a summary by the Senate Finance Committee, the legislation delays by 10 years an important rule that would have helped low-income Medicare beneficiaries enroll in programs that help them pay for Medicare premiums and cost-sharing. This change will result in more than 1 million low-income Medicare beneficiaries losing this assistance. This cut is a direct assault on low-income Medicare beneficiaries.
The legislation also includes a provision that is harmful and sets a chilling precedent—it allows Medicare coverage to be stripped away from currently enrolled beneficiaries. The provision applies to certain categories of immigrants, even when they have sufficient work history and meet the requirements to currently enroll in Medicare.
The legislation also delays the nursing home staffing rule by 10 years. The final rule requires a registered nurse be onsite 24/7 and that each resident receive, on average, 3.48 hours per day of nursing care, among other changes. Research estimated that implementation of the staffing rule would save 13,000 residents’ lives each year. The legislation will harm the health, safety, and lives of nursing home residents.
The Center for Medicare Advocacy urges Congress to reject the crushing cuts to the Medicaid program and harmful Medicare provisions in the recently released tax legislation. These cuts are cruel; they will inflict real pain on beneficiaries and their families. Congress must act to protect the millions of individuals, including Medicare beneficiaries, who rely on Medicaid for life-saving coverage.
May 15, 2025 – Co-Director David Lipschutz