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How Medicaid Cuts Might Shift Costs to Older Adults

As healthcare costs continue to rise, many older adults are already struggling to afford the care they need. Medicaid— a joint federal–state program that helps cover medical costs for people with limited income and resources—plays an essential role in filling the gaps Medicare does not cover, including nursing home care and home health care. Recently enacted legislation known as the One Big Beautiful Bill Act (H.R. 1) includes changes that the Congressional Budget Office estimates will reduce Medicaid spending by nearly $1 trillion over the next decade.

July 25, 2025
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The infographic below illustrates how much older adults currently spend out of pocket, how much Medicaid contributes to their care, and why these new cuts could intensify financial pressure on aging Americans and their families.

Infographic of 65+ health spending flows ($1.24T), showing Medicaid, out‑of‑pocket and other payer shares and warning Medicaid cuts raise older adults' costs.

Key Takeaways:

  • Rising concern about affordability
    The vast majority of adults (86%) are concerned about the cost of healthcare as they age, according to West Health–Gallup polling.

  • Older adults are already paying significantly out of pocket
    In 2020— the most recent year of available data—older adults spent $165 billion out of pocket on healthcare not covered by Medicare. Medicaid provided another $123 billion to help lower-income older adults avoid unaffordable medical bills.

  • Medicaid cuts will shift more costs onto families
    Recently enacted Medicaid cuts are likely to push even more expenses onto older adults and their families, increasing the risk of delaying or forgoing needed care, and forcing difficult trade-offs between healthcare and basic necessities like food, rent, and transportation.

About the Data:

The information and analysis featured in this infographic draw from the following sources:

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How Medicaid Cuts Might Shift Costs to Older Adults

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