Medicaid, a critical health insurance program for 79 million low-income Americans, plays a particularly vital role for adults aged 50 to 64, covering over 16 million people in this group. Proposed federal budget cuts, however, could significantly reduce Medicaid’s reach, putting millions at risk of losing health coverage.
A recent congressional budget resolution directs $880 billion in program cuts over 10 years to offset the costs of extending the 2017 tax cuts. Because Medicare has been declared off-limits, Medicaid is expected to bear the brunt of these reductions.
Two changes are under serious consideration:
- Cutting federal funding for Medicaid expansion: This would reduce the federal share of costs for the Affordable Care Act (ACA) expansion population from 90 percent to as low as 50 percent, potentially prompting many states to roll back coverage. Twelve states already have laws that would trigger partial or full withdrawal from Medicaid expansion under such conditions. An estimated 3 million people aged 50–64 could lose insurance if these changes take effect.
- Imposing work requirements: Proposals to tie Medicaid eligibility to employment could disproportionately impact older adults. Around 6.1 million 50–64-year-olds currently on Medicaid are not receiving Social Security Disability Insurance or Medicare and could be subject to these rules. Past evidence, including from Arkansas, shows work requirements reduce coverage without increasing employment. The near-elderly, often managing chronic health conditions and facing age-related job discrimination, would likely experience higher rates of disenrollment and worse health outcomes.
Coverage losses for this age group could have wide-reaching effects: reduced access to care, worsening chronic conditions, and increased mortality. Some research suggests that these losses may even lead to higher Medicare costs down the line when these individuals age into the program.
Read a much more detailed breakdown of the budget cuts and their possible impact here.
We believe that one vital way to improve the quality of life for older Americans is by making retirement more affordable. That’s why we are urging Congress to pass a bill we call the Elder Relief Act. See what we are doing here.