Medicaid and Medicare Work Together for Seniors
While Medicare is the primary health insurance program for Americans over 65, it does not cover many of the services that seniors need most — including long-term nursing home care and extended home health services. Medicaid fills these critical gaps, and approximately 12 million Americans are "dual-eligible," meaning they qualify for both Medicare and Medicaid. For these individuals, Medicaid covers costs that Medicare does not, including long-term care, dental services, vision care, and help with Medicare premiums and copays.
Without Medicaid, millions of seniors would face impossible choices between paying for their care and paying for food, housing, and other basic needs. The average annual cost of a private room in a nursing home exceeds $100,000, a figure that is far beyond the reach of most older Americans. Medicaid makes this care accessible by covering these costs for those who qualify.
The dual-eligible population is among the most medically complex and costly to serve, but Medicaid's role in coordinating their care has been shown to improve outcomes and reduce unnecessary hospitalizations. Cutting Medicaid would not eliminate the need for these services — it would simply shift the cost to seniors, their families, and already-strained state budgets.
Long-Term Care Depends on Medicaid
Medicaid is the nation's largest payer for long-term care services and supports, funding more than 60 percent of all nursing home residents in the United States. For many seniors, Medicaid coverage of long-term care is not a choice but a necessity — they have exhausted their savings, spent down their assets, and have no other way to pay for the around-the-clock care they require.
Proposed cuts of more than $1 trillion to Medicaid would devastate the long-term care system. Nursing homes that depend on Medicaid reimbursement — which already pays below the actual cost of care in most states — would face even deeper financial shortfalls. Many would be forced to reduce staff, limit admissions, or close entirely, leaving seniors without access to the care they need.
The ripple effects would be felt far beyond nursing facilities. Family caregivers, who already provide an estimated $600 billion in unpaid care annually, would shoulder an even greater burden. Many would be forced to reduce work hours or leave the workforce entirely, with significant economic consequences for their own financial security.
Home and Community-Based Services Keep Seniors Independent
One of Medicaid's most important — and cost-effective — roles is funding home and community-based services that allow seniors to remain in their homes rather than moving to institutional settings. These services include personal care aides, home health visits, meal delivery, adult day programs, and assistive technology. Most seniors prefer to age in place, and Medicaid makes this possible for those who cannot afford to pay for these services out of pocket.
Despite strong demand, many states maintain long waiting lists for Medicaid home and community-based services. The American Rescue Plan provided a temporary boost in funding to help states reduce these waitlists, but that enhanced funding has expired. Cutting Medicaid further would push more seniors off these services and into more expensive — and less preferred — institutional care.
Rising Costs in 2026 Make Medicaid More Critical Than Ever
Health care costs for older adults continue to rise sharply in 2026, driven by inflation in prescription drug prices, staffing shortages in the care industry, and the growing number of Americans reaching retirement age. The Baby Boomer generation is now fully in the Medicare-eligible age range, and the demand for Medicaid-funded long-term care is expected to surge over the next decade.
At precisely the moment when the nation needs to be investing in senior care infrastructure, proposals to cut Medicaid would move in the opposite direction. More than 20 million Americans already face a "sick tax" in the form of higher costs and reduced access to care, and seniors on fixed incomes are among the most vulnerable to these burdens.
Protecting Medicaid is not just about preserving a program — it is about honoring the commitment that Americans have made to ensure that their parents, grandparents, and neighbors can age with dignity, access the care they need, and live their final years with security rather than fear.