From DC: Congress Eyes Major Medicaid & SNAP Cuts, New Report Warns of HCBS Reductions, and More

April 25, 2025

From DC is Justice in Aging’s weekly roundup of national news and resources about issues impacting older adults. To receive From DC in your inbox as soon as its published, sign up for our mailing list.

Here’s what we’re watching in Washington:

Leaked 2026 HHS Budget Draft Reveals Threat to Critical Programs for Older Adults

Last week, a draft of the Department of Health and Human Services (HHS) 2026 Discretionary Budget Passback from the Office of Management and Budget was leaked to the public. While this document is not final, it previews plans for drastic cuts to the HHS budget, totaling $40 billion for Fiscal Year 2026.

The proposed budget would eliminate funding for many critical basic needs programs for older adults, including the Long-Term Care Ombudsman Program, support for Adult Protective Services programs, State Health Insurance Assistance Programs (SHIP), Elder Rights Support Activities, and more. If these cuts take place, older adults facing nursing facility eviction, abuse and exploitation, or health care issues will have less support and fewer services available to them to navigate these difficult situations.

The President’s Budget is usually seen as a messaging document, as Congress has the power to make budget decisions. However, the message the Administration is sending is clear: the HHS “reorganization” and dismantling of the Administration for Community Living that occurred earlier this month is not only a shifting of programs to different agencies—it is also preparing to eliminate many critical services for older adults.

Justice in Aging and our partners are carefully monitoring the budget process for both FY 25 and FY 26, and we will inform our network of any opportunities for action.

Congress Rushing to Pass Budget Bill with Unprecedented Medicaid and SNAP Cuts by Memorial Day

Congress is wrapping up a two-week recess and will be back in Washington, DC, next week. Committees in the House are expected to begin hearings to markup legislation to enact the tax and spending cuts outlined in the budget resolution that passed both chambers earlier this month.

The resolution calls for massive and unprecedented cuts to Medicaid, the Supplemental Nutrition Assistance Program (SNAP), and other programs older adults rely on to meet their basic needs. These cuts to basic needs programs would be used to finance tax breaks for the wealthy and corporations and other harmful policies like immigration enforcement.

Speaker Johnson is aiming to finalize a comprehensive budget bill for a vote by the full House before Memorial Day. The expectation is that if the House can pass the budget bill, the Senate will not go through its own committee process but instead try to move the bill for a vote by the full Senate as quickly as possible.

This means we must activate now to ensure the House does not include cuts to Medicaid, SNAP, or any other basic needs programs in the budget bill and tell the Senate they should make clear they will not vote for any bill that does.

Contact your lawmakers both in DC and in your state and urge them to reject any cuts to Medicaid and SNAP. See our resources on Medicaid Defense, including our new fact sheet with SAGE: LGBTQ+ Older Adults Can’t Afford Cuts to Medicaid.

New Analysis of Past Medicaid Funding Cuts Shows States Will Cut HCBS

In a recent Health Affairs article, researchers explain how states responded to budget shortfalls after the Great Recession (2010-12) when Congress prematurely ended enhanced federal Medicaid funding to states. Every single state made cuts to their Medicaid home and community-based services (HCBS) programs, either reducing benefits or reducing the number of people covered, or both. Waiting lists for HCBS also grew in many states.

HCBS are typically the only source of paid long-term care at home and are key to helping older adults age in place. Yet, because federal law does not require states to cover HCBS and HCBS comprise the majority of optional Medicaid spending, these programs are often the first to be cut when states face budget shortfalls.

The new analysis demonstrates that if Congress cuts funding or shifts any costs onto states for Medicaid or SNAP, states will respond by taking away home-based care for older adults and people with disabilities–the exact groups Republican leadership is claiming they want to protect.

Additional analysis demonstrates that cuts to HCBS would lead to increased nursing home stays–which states are required to cover–at increased costs to Medicaid. The researchers estimate that reducing HCBS spending by even 15% would increase the number of days people age 50 and older with Medicaid are in nursing homes by 1.5 million, at a cost of $467 million.

Read the full analysis and find state-by-state data on HCBS cuts. Use this data and our fact sheet to show Congress and other policymakers in your state that Cutting Medicaid Harms Older Adults No Matter How It’s Sliced.