My mother-in-law has suffered a fall which broke her elbow and shoulder in 2025. Then she was kicked out of the skilled care nursing facility, just as she was improving with her physical therapy daily. At age 88, she was given 9 days total under her insurance. Then she decompensated at home, unable to leave her bed, unable to walk or clean herself. Her husband could not care properly for her, as he is an elderly person as well. Then, with bed sores, a respiratory infection caused by inactivity, kidney issues and dangerously high blood pressure, she was hospitalized once again. She has been in the hospital for over a month now. The doctors are not going to release her into another skilled care nursing facility at this time because the insurance will boot her out prematurely again.I have seen first-hand the systematic shifts which do not truly care for our elders as they face their golden years. (As of the publishing date, my mother-in-law has passed away.)
The United States health care landscape for older Americans has faced increasing turbulence since President Trump’s return to the White House in 2025. At the center of this shift is the One Big Beautiful Bill Act, a sweeping federal budget and policy law signed in July 2025 that includes the largest cuts to Medicaid in U.S. history — more than $1 trillion in reductions designed to restrain federal spending on social safety-net programs. Critics argue this law threatens coverage for millions of vulnerable people, including older adults who rely on Medicaid for long-term care and Medicare supplemental coverage, by making eligibility and enrollment more burdensome and reducing federal support for states’ programs.
Medicaid cuts, in particular, pose profound risks to seniors’ access to affordable care. Medicaid is not only essential for low-income Americans of all ages but also a primary payer of long-term services and supports — including nursing home care and home health services that Medicare itself often does not fully cover. Analysis from public health experts suggests these cuts and new requirements could lead to millions of people losing Medicaid coverage entirely, which in turn may make it significantly harder for older adults to access preventive care and necessary treatments. (Johns Hopkins Public Health)
Another major change under the new law is the implementation of Medicaid work or “community engagement” requirements, which require many beneficiaries (though not typically seniors) to meet monthly activity thresholds to retain coverage. While exemptions exist for people with certain disabilities, advocates warn that complex reporting and administrative hurdles — already documented from prior state-level experiences — can inadvertently lead to eligible individuals losing benefits, including older adults who may be retired but still reliant on Medicaid for critical services. (Johns Hopkins Public Health)
The potential impact on Medicare is also a growing concern. Nonpartisan analyses cite Congressional Budget Office estimates that automatic budget-cut triggers tied to Trump’s tax and spending law could force nearly $500 billion in cuts to Medicare programs between 2027 and 2034 unless Congress intervenes — even though senior leaders pledged not to reduce Medicare benefits. Such cuts could strain care delivery, particularly in rural areas where provider networks are already fragile. (AP News)
Finally, many Americans — including older adults — are expressing anxiety about overall health care affordability and access. Recent polling shows broad concern about the direction of U.S. health care under Trump’s leadership, with a significant share describing the system as in crisis and citing cost as a central issue. Expiring ACA subsidies and changes to eligibility rules in federal marketplaces further complicate access for older adults who fall into coverage gaps. (thedailybeast.com)
Feeling powerless is exactly what allows harmful systems to persist — but there are concrete, ethical, and effective things we can do. None of them require perfection or burnout; they require participation.
1. Advocate loudly and consistently — especially at the local level.
Federal policy matters, but state and county decisions often determine whether seniors actually receive care. Attend town halls, call state legislators, and submit public comments on Medicaid waivers, nursing home regulations, and senior services funding. One call or email may feel small, but elected officials track volume. Seniors and caregivers are among the most influential voting blocs when they organize.
2. Support and strengthen watchdog organizations.
Groups like AARP, the National Consumer Voice for Quality Long-Term Care, Justice in Aging, and local senior advocacy coalitions monitor legislation, file lawsuits, and expose neglect. Donating, sharing their alerts, or volunteering amplifies their reach. These organizations often do the heavy lifting individuals can’t do alone — and they rely on public engagement to stay effective.
3. Protect seniors directly in your community.
Check in on older neighbors. Help them navigate insurance paperwork, appeals, or enrollment deadlines. Many seniors lose coverage not because they’re ineligible, but because systems are intentionally complex. Community-level support — rides to appointments, help filling out forms, accompaniment to hearings — can literally keep people housed, fed, and medically stable.
4. Tell the truth — publicly and persistently.
Stories move policy. Write op-eds, blog posts, or letters to editors. Share real experiences from caregivers, clinicians, and seniors themselves (with consent). Silence allows cuts to be framed as “efficiency.” Naming them as what they are — disinvestment, rationing, and neglect — reframes the narrative and builds pressure.
5. Vote with health care in mind — every time.
Presidential elections matter, but so do primaries, midterms, judicial races, and ballot measures. Research candidates’ positions on Medicaid, Medicare, long-term care staffing ratios, and elder protections. Encourage seniors to vote, help them access mail-in ballots, and challenge voter suppression that disproportionately affects older adults and people with disabilities.
Change doesn’t come from one heroic act. It comes from many people refusing to normalize harm. When we stay engaged — informed, vocal, and connected — we make it harder for seniors’ health care to be quietly dismantled.
Thank you for reading and caring. After all, we are all headed into senior territory if we live long enough.
Blessings,
KJ Landis
@superiorself on Instagram and X
@SuperiorSelf channel on YouTube
@superiorselfwithkjlandis on TikTok
[email protected]
Books available everywhere!
The United States health care landscape for older Americans has faced increasing turbulence since President Trump’s return to the White House in 2025. At the center of this shift is the One Big Beautiful Bill Act, a sweeping federal budget and policy law signed in July 2025 that includes the largest cuts to Medicaid in U.S. history — more than $1 trillion in reductions designed to restrain federal spending on social safety-net programs. Critics argue this law threatens coverage for millions of vulnerable people, including older adults who rely on Medicaid for long-term care and Medicare supplemental coverage, by making eligibility and enrollment more burdensome and reducing federal support for states’ programs.
Medicaid cuts, in particular, pose profound risks to seniors’ access to affordable care. Medicaid is not only essential for low-income Americans of all ages but also a primary payer of long-term services and supports — including nursing home care and home health services that Medicare itself often does not fully cover. Analysis from public health experts suggests these cuts and new requirements could lead to millions of people losing Medicaid coverage entirely, which in turn may make it significantly harder for older adults to access preventive care and necessary treatments. (Johns Hopkins Public Health)
Another major change under the new law is the implementation of Medicaid work or “community engagement” requirements, which require many beneficiaries (though not typically seniors) to meet monthly activity thresholds to retain coverage. While exemptions exist for people with certain disabilities, advocates warn that complex reporting and administrative hurdles — already documented from prior state-level experiences — can inadvertently lead to eligible individuals losing benefits, including older adults who may be retired but still reliant on Medicaid for critical services. (Johns Hopkins Public Health)
The potential impact on Medicare is also a growing concern. Nonpartisan analyses cite Congressional Budget Office estimates that automatic budget-cut triggers tied to Trump’s tax and spending law could force nearly $500 billion in cuts to Medicare programs between 2027 and 2034 unless Congress intervenes — even though senior leaders pledged not to reduce Medicare benefits. Such cuts could strain care delivery, particularly in rural areas where provider networks are already fragile. (AP News)
Finally, many Americans — including older adults — are expressing anxiety about overall health care affordability and access. Recent polling shows broad concern about the direction of U.S. health care under Trump’s leadership, with a significant share describing the system as in crisis and citing cost as a central issue. Expiring ACA subsidies and changes to eligibility rules in federal marketplaces further complicate access for older adults who fall into coverage gaps. (thedailybeast.com)
Feeling powerless is exactly what allows harmful systems to persist — but there are concrete, ethical, and effective things we can do. None of them require perfection or burnout; they require participation.
1. Advocate loudly and consistently — especially at the local level.
Federal policy matters, but state and county decisions often determine whether seniors actually receive care. Attend town halls, call state legislators, and submit public comments on Medicaid waivers, nursing home regulations, and senior services funding. One call or email may feel small, but elected officials track volume. Seniors and caregivers are among the most influential voting blocs when they organize.
2. Support and strengthen watchdog organizations.
Groups like AARP, the National Consumer Voice for Quality Long-Term Care, Justice in Aging, and local senior advocacy coalitions monitor legislation, file lawsuits, and expose neglect. Donating, sharing their alerts, or volunteering amplifies their reach. These organizations often do the heavy lifting individuals can’t do alone — and they rely on public engagement to stay effective.
3. Protect seniors directly in your community.
Check in on older neighbors. Help them navigate insurance paperwork, appeals, or enrollment deadlines. Many seniors lose coverage not because they’re ineligible, but because systems are intentionally complex. Community-level support — rides to appointments, help filling out forms, accompaniment to hearings — can literally keep people housed, fed, and medically stable.
4. Tell the truth — publicly and persistently.
Stories move policy. Write op-eds, blog posts, or letters to editors. Share real experiences from caregivers, clinicians, and seniors themselves (with consent). Silence allows cuts to be framed as “efficiency.” Naming them as what they are — disinvestment, rationing, and neglect — reframes the narrative and builds pressure.
5. Vote with health care in mind — every time.
Presidential elections matter, but so do primaries, midterms, judicial races, and ballot measures. Research candidates’ positions on Medicaid, Medicare, long-term care staffing ratios, and elder protections. Encourage seniors to vote, help them access mail-in ballots, and challenge voter suppression that disproportionately affects older adults and people with disabilities.
Change doesn’t come from one heroic act. It comes from many people refusing to normalize harm. When we stay engaged — informed, vocal, and connected — we make it harder for seniors’ health care to be quietly dismantled.
Thank you for reading and caring. After all, we are all headed into senior territory if we live long enough.
Blessings,
KJ Landis
@superiorself on Instagram and X
@SuperiorSelf channel on YouTube
@superiorselfwithkjlandis on TikTok
[email protected]
Books available everywhere!
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