Seniors

Proposed changes in eligibility rules in both SNAP and Medicaid may jeopardize some people’s access to both adequate food and health care if various provisions of the bill take effect, in part because there is a significant overlap in eligibility requirements for Medicaid and SNAP across states. Four in 10 (40%) Medicaid enrollees receive SNAP benefits.

The Trump Administration and Congress are moving quickly to pass legislation that could have significant implications for health coverage of older Americans. The House-passed reconciliation bill awaiting action by the full Senate, known as the One Big Beautiful Bill, includes several provisions that would affect health insurance coverage and well-being of older adults ages 50 and older, including those who are covered by Medicare.

People with low incomes and limited financial resources can qualify for the Medicare Savings Programs, through which state Medicaid programs provide financial assistance with Medicare premiums and cost sharing. However, provisions in the GOP’s budget reconciliation bill would make it harder for people to enroll in these programs. Many people with Medicare are facing a relatively high financial burden associated with paying Part B premiums, and the reconciliation bill could drive that number higher.

On May 22, the House passed a budget reconciliation bill that includes significant changes to the Medicaid program. The Congressional Budget Office (CBO) estimated that the bill would reduce federal Medicaid spending by $793 billion and reduce the number of people covered by Medicaid in 2034 by 10.3 million. Many of the reductions in coverage will be among the 22 million Medicaid enrollees ages 50 and older.

This brief highlights some of the key federal agencies and offices that play a role in making Medicare work and, to the extent possible, describes the recent staffing and organizational changes made by the Trump administration that could affect the operations of Medicare in the future.

The Trump administration is proposing a reorganization and staffing cuts at HHS that create uncertainty about the potential effects on older adults, who receive services authorized under the Older Americans Act. This brief provides an overview of programs and services provided under the Older Americans Act, the role played by the Administration for Community Living in administering these programs, and trends in program funding and service utilization by older adults.

The substantial Medicaid savings in the reconciliation bill that has been passed by the House could have major implications for nearly 15,000 federally certified nursing facilities and the 1.2 million people living in them. Nursing facilities provide medical and personal care services for older adults and people with disabilities, and Medicaid covered 44% of long-term institutional care costs in 2023.

KFF’s Survey of Medicaid Financial Eligibility for Older Adults & People with Disabilities, conducted in March 2025 by KFF and Watts Health Policy Consulting, provides a baseline of Medicaid eligibility as states return to normal operations after the end of the COVID-19 pandemic and ahead of potential changes to the Medicaid program.

This issue brief provides information about some of the services Medicaid provides in assisted living facilities from KFF’s most recent survey of state Medicaid HCBS home care programs.

Nearly 1 in 4 Medicaid enrollees are eligible for the program because they are ages 65 and older or have a disability, and they have higher per-enrollee costs than other enrollees. Proposals to limit federal spending on Medicaid may create incentives for states to drop or reduce their eligibility or coverage for seniors and people with disabilities in response to fewer federal revenues. Considering the proposed reductions in Medicaid spending, this issue brief describes Medicaid eligibility pathways, enrollment, and spending among people eligible through the age and disability-related pathways.