July marks the 60th anniversary of Medicare, Medicaid and the Older Americans Act (OAA).
Along with Social Security, these programs form the bedrock of health and economic well-being for older Americans. Signed into law in 1965 by President Lyndon Johnson, they help ensure that every older adult has access to basic health care and income, as well as community services.
Now, Medicaid faces substantial cuts in the the One Big Beautiful Bill Act, which President Donald Trump signed on July 4. Opponents predict that millions of older people and those who care for them will lose coverage under new requirements. Some seniors may no longer be able to afford their Medicare premiums or prescription medication, according to AARP, while those in their 50s and 60s may not be able to meet some of the newly imposed work requirements, jeopardizing their own health and their caregiving responsibilities.
The steep budget cuts will also trigger major issues for some Medicare recipients, according to Juliette Cubanski, Ph.D., deputy director of KFF’s program on Medicare policy.
“The Congressional Budget Office estimates that 1.3 million people with Medicare will lose their Medicaid benefits because of the delays in implementation of the Medicaid eligibility and enrollment rules,” she said.
Additionally, federal spending will be so high as a result of this bill, that it triggers what’s known as sequestration of Medicare, meaning it’s an across-the-board cut to all health care providers paid by Medicare, Gretchen Jacobson, Ph.D., vice president of Medicare for The Commonwealth Fund, said.
“So, you can think of it as every check that goes out the door by the Medicare program is reduced by 4%,” Jacobson said. “It would affect doctors, hospitals, Medicare Advantage plans, Part D plans — every health care provider paid by Medicare.”
Meanwhile, the Supplemental Nutrition Assistance Program (SNAP), which helps people with their groceries and supports better nutrition among people with low incomes, also faces deep cuts — meaning millions of older people could go hungry, according to the Medicare Rights Center.
Older Americans Act
One bright spot in all of this is the reintroduction of the Older Americans Act reauthorization for 2025, a move that had been set aside for months while Congress focused on other priorities.
“Not only does the Older Americans Act save lives and ease human suffering, it saves money. We can choose to continue to waste billions of dollars on emergency room visits and unnecessary hospital stays, or we can provide older Americans with the resources and the services they need to live healthier, more secure, and more dignified lives,” Sen. Bernie Sanders (I-Vt.) said in a statement. “In my view, it is our responsibility not simply to reauthorize this legislation and maintain the status quo. It is our responsibility to expand the Older Americans Act so that every vulnerable senior in America can receive the services that they need.”
The legislation would support OAA programs through fiscal year 2030, promote innovation and flexibility, strengthen program integrity and better support family caregivers and direct care workers, according to the HELP committee. The bill also takes steps to improve services for Tribal seniors and those with disabilities in their communities.
However, dozens of OAA programs are slated for reduction or elimination in HHS’s budget plan for fiscal year 2026. Funding for home-delivered meals, transportation services, falls prevention and elder abuse prevention programs, among others, are either frozen at current levels, significantly cut or will disappear.
HHS Secretary Robert F. Kennedy, Jr. has already begun disbanding the Administration for Community Living, the agency that administers OAA programs and services. Some existing programs will move to the Centers for Medicare and Medicaid, some to the Administration for Children and Families, and some to the Office of the Assistant Secretary for Planning and Evaluation. Hundreds of staffers have already lost their jobs, some regional offices have shut down, and the separation of programs will make it more difficult to effectively administer the programs the ACL once oversaw, an April 2025 report from The Urban Institute concluded.
“By breaking apart the coordination and delivery of programs under the Older Americans Act, the administration is jeopardizing the health, independence and dignity of millions of older adults and their caregivers,” writes Nathan Boucher in The Hill.
That’s the opposite intention of the programs LBJ fought to pass in 1965.
“The need for this action is plain, and it’s so clear indeed,” Johnson said on July 30, 1965, when he signed legislation establishing Medicare and Medicaid. “What we marvel at isn’t the need for this bill. What we marvel at is that it took so many years to pass it.”
Resources
- What to Know About the Older Americans Act and the Services it Provides to Older Adults, KFF.
- Older Americans Act Reauthorization Act of 2025 Introduced, National Consumer Voice for Quality Long Term Care.
- What Trump’s 2026 Budget Would Mean For Older Adults, Howard Gleckman, Forbes.
- Medicaid at 60, Journal of Health Politics, Policy and Law.
- Celebrating Milestones in Elder Care: A Look Back—and Forward—at Aging Policy in 2025, Benjamin Rose Institute on Aging.
Editor’s note: This article was updated with new information on July 9, 2025.
