July 3, 2025 Washington, DC — Response to the House of Representatives’ vote advancing H.R. 1, One Big Beautiful Bill (OBBB) Act, to be signed into law by President Donald Trump from the head of the leading national association representing over 5,4000 nonprofit and mission-driven providers of aging services:

“This legislation deals a significant blow to a core element of our country’s social safety net: Medicaid. The consequences will not be pretty. Millions of Americans will lose health insurance coverage resulting from cuts to Medicaid and to Affordable Care Act Marketplace coverage. Due to the level of deficit this bill will create, Medicare payments to providers may be reduced by 4% for the next ten years. Bandaids included in the bill such as only-freezing-but-not-reducing nursing home provider taxes, and the creation of a rural health transformation fund–touted as protections for older adults and aging services providers–will soon prove ill-equipped to stop OBBB’s damage. And, as states respond to OBBB-created craters in their budgets due to reduced federal Medicaid contributions, the suffering will begin,” said Katie Smith Sloan, president and CEO, LeadingAge.

Older adults and their families will encounter more challenges in accessing health insurance and needed services and care–whether provided in nursing homes or assisted living, by home health and home care agencies, via Programs for All-Inclusive Care for the Elderly and adult day programs or in other settings. Residents of affordable senior housing will be at risk of losing insurance due to onerous work requirements and increased eligibility checks, and may also lose access to food assistance. And, the difficulties that our mission-driven and nonprofit members already navigate to deliver care and services, including recruiting and retaining staff, will grow. Caregiving responsibilities will fall to family members, who, while also possibly struggling to access their own health care, will have to rearrange their lives to fill in the sizable gaps that Congress has created with the passage of this bill.

Now at nearly 20 percent of the total population, the number of Americans age 65 and older is steadily increasing. Make no mistake: this harmful, cold-hearted bill will wreak havoc on our country’s fragile aging services infrastructure–at a time when demand for the Medicare and Medicaid supported services it delivers is growing.

The protection–-not the destruction–of that infrastructure and those services must be the priority. It is ours: we oppose this legislation and remain steadfast in our commitment to preserve and expand our nation’s social safety net.”