May 12, 2025 Washington, DC — Ahead of the House Energy and Commerce Committee’s markup of proposed legislation impacting changes to the Medicaid program, Katie Smith Sloan, president and CEO of LeadingAge—the association representing nonprofit aging services providers—emphasized Medicaid’s critical role in enabling older adults to have access to care and services by funding, and supporting the providers who deliver them.  

“Medicaid isn’t just a safety net—it’s a lifeline for millions of older adults and their families.  Medicaid is the only public payer for long term services and supports. As the number of Americans age 65 and older surges and the care workforce shrinks, slashing or restricting Medicaid funding isn’t just irresponsible; it’s dangerous. The number of people estimated to lose coverage under these proposals is at least 8.7 million, and it will likely be more. Medicaid is an interconnected ecosystem—if you target one piece, the whole system will be impacted. 

We have been told that the intent of all these policies is not to harm older adults, but they will. For example, the provider tax moratorium limits states’ flexibility to adjust their taxes based on state needs or to redirect these funds where they are needed most, which could threaten the viability of our members and limit access for those they serve. The changes to the uniformity requirements for health care taxes will also limit state flexibilities to meet the needs of their communities.  

Limiting retroactive eligibility to a one-month lookback will result in access to care issues for those seeking nursing home placement, as well as putting financial strain on our members. Imposing cost neutrality requirements on certain demonstration waivers handcuffs states’ ability to pilot programs that wrap additional services around high-cost and aging populations. 

The work requirements policy will be administratively burdensome, costly for states, and is aimed at keeping people off coverage. We have members who serve older adults living in HUD-assisted housing and elsewhere in the community who will be subject to the work requirement and may lose access to needed coverage as a result of these confusing and burdensome requirements.

The policies in the bill represent dangerous cuts to Medicaid. Cuts at the federal level force states into impossible choices: reduce services, limit access, or slash provider payments. No matter the route, the result is the same: older adults, their families, and the providers who serve them, lose. 

We urge Congress to protect Medicaid and the aging services infrastructure that helps older Americans age with dignity, not desperation.”