Medicaid on the Brink: What’s at Stake for Michigan’s Seniors and Caregivers

Congressional House Republicans have just passed drastic cuts to Medicaid in the House Reconciliation Bill, which will now advance to the Senate. Medicaid is the primary payer for long-term services and supports (LTSS) and these potential cuts will place a  heavy burden on family caregivers and older adults alike. For decades, Medicaid has been a critical safety net for older adults and adults with disabilities, providing access to long-term care services that allow people to age with dignity at home and in their communities. Medicaid provides crucial access to LTSS, which is not typically covered by private insurance or Medicare. In fact, nationally 1 in 3 dollars of Medicaid funding goes to support those on Medicare. Every state offers home and community-based services (HCBS) through Medicaid, supporting not just individuals receiving care, but also the millions of unpaid family caregivers who rely on these programs for essential respite, in-home help, and case management support.

Medicaid is the country’s largest provider of health insurance and one of the most cost-efficient forms of coverage. Medicaid provides comprehensive coverage to more than one in four Michiganders for a total of 2.6 million individuals. In Michigan alone, Medicaid supports LTSS for 1 in 6 Medicare beneficiaries and 3 in 5 nursing home residents and within the AgeWays service region, 19% of all the individuals on Medicaid are older adults or an adult with a disability. Access to Medicaid is not only critical to the health and wellbeing of older adults and adults with disabilities but also ensures that both formal and informal caregivers are not left to manage complex care needs entirely on their own.

Proposed cuts under the 2025 Reconciliation Bill could leave the 168,000 older adults who rely on Medicaid for their long-term care coverage without a place to turn. The proposed changes, including reducing federal matching rates, Medicaid work requirements, provider tax reform, and implementing per-capita caps, would all have a significant effect on the state budget, causing loss of coverage for those with the greatest need. Around 70% of the state’s Medicaid budget comes from the federal government and any cuts would force Michigan to make difficult decisions, ultimately reducing access to healthcare for our most vulnerable. These cuts would also fall hard on family caregivers, who already provide the bulk of care without pay, and direct care workers who often rely on Medicaid for their own coverage.

We are at a pivotal moment. Medicaid proposals currently under consideration would have detrimental effects on older adults, adults with disabilities, and caregivers in Michigan who rely on Medicaid for their health coverage. The impact these proposed cuts would have on home and community-based services as an option for long-term care coverage would be extremely costly.

Now is the time to act. Call your Members of Congress and urge them to reject cuts to Medicaid. Tell them that preserving and strengthening Medicaid is essential to keeping older adults at home and supporting the family caregivers who make that possible.