Adult Day Services Policy & Advocacy
Call to Action!
NADSA Statement Addressing Medicaid Threats
Bill Zagorski, Chair, NADSA Board of Directors, has issued the following statement to address the potential cuts to Medicaid funding.
One in five Americans depend on Medicaid for health insurance and other basic life needs, and roughly two-thirds of Adult Day Services participants utilize Medicaid to pay for at least some of the cost of their attendance at centers. Many of these Americans already live in some of the poorest and rural communities in America. The February 25th House of Representatives budget vote created a real and immediate threat to Medicaid funding in every state. The National Adult Day Services Association is calling on Congress to protect Medicaid funding!
On Wednesday, March 5th, the Congressional Budget Office confirmed that the cost reduction of $880 billion assigned to the House Committee on Energy and Commerce for federal health care spending by the House’s budget, is NOT possible without cuts to Medicaid or the Children’s Health Insurance Program. Even if the Energy and Commerce Committee eliminated every program excluding those safety net benefits, the maximum savings would be $135 billion — far less than the $880 billion called for in the budget resolution.
Congress must protect Medicaid. As stated above, the Congressional Budget Office has shown the only path to saving the $880 billion outlined in the proposed House budget would be by reducing more than $700 billion from Medicaid, and the Children’s Health Insurance Program. Approximately one-third, or nearly $250 billion will target older adults.
These funding cuts to Medicaid will decimate state budgets and negatively impact Adult Day Services centers, their employees, their center’s participants, and their participants caregivers. Adult Day Services continues be the most effective means of delivering health care and long-term care to low income, vulnerable and disabled individuals by the annual independently funded Genworth and CareScout Cost of Care Survey. Congress must protect Medicaid funding or seniors and disabled adults will be forced into more costly and restrictive institutional care or be placed on extensive waiting lists without care. It is critically important that the US Congressional Representatives and US Senators protect Medicaid funding during the budget reconciliation process.
We Must Protect Medicaid Funding for Adult Day Services!
It is essential that everyone reading this message contact your state’s Republican US Senators and US Congressional Representatives today by phone and email and tell them to protect Medicaid! Here is the phone number for the United States Capitol switchboard at (202) 224-3121. A switchboard operator will connect you directly with the Senate office you request. Or, you can look up your state’s US Senators and contact them by email directly on their official website page: Contact US Senate; Contact the House of Representatives.
NADSA has developed a tool kit which provides important facts on how Medicaid cuts would detrimentally impact Adult Day Services; a draft letter that can be customized for mailing/emailing to your Congressional Representative and Senators; and, a list of the House Committee on Energy and Commerce Republican Representatives and links to their offices. The House Committee on Energy and Commerce has jurisdiction over the potential cuts to Medicaid. To download the tool kit, click on the following link: ADS Medicaid Tool Kit.
Additionally, please feel free to adapt this message or use the below text for phone and email contacts.
One in five Americans depend on Medicaid for health insurance and other basic life needs. More specifically, roughly two-thirds of Adult Day Services participants utilize Medicaid to pay for at least some of the cost of their attendance at centers. The Congressional Business Office has confirmed the only path for saving the estimated $880 billion in healthcare spending is through reductions to Medicaid and the Children’s Health Insurance Plan. Cuts to Medicaid will have an immediate impact on every state budget and force exceedingly difficult budgetary decisions that could dramatically impact your center, your employees, your participants, and their caregivers.
- Medicaid has been shown to be the most effective means of delivering health care and long-term care to low income, vulnerable and disabled individuals across the country.
- The annual independently funded Genworth and CareScout Cost of Care Survey highlights the cost savings of Adult Day Services vs. in-home care, assisted living or nursing home care by as much as a five to one ratio.
- The federal government has supported each state’s delivery model by matching state funds to deliver these services in each state.
- Any cuts to Medicaid will decimate state budgets.
- Home and Community-Based Services (HCBS) including Adult Day Services are generally not mandated services and states will be forced to cut funding as a first line of budget transfers.
- HCBS, including Adult Day Services, are more cost-effective and beneficial than institutional care but all Long-Term Services and Supports (LTSS) and long-term care must be protected in Medicaid.
- Seniors and disabled adults need your immediate support or will be forced into more costly and more restrictive institutional care or extensive waiting lists without care.
- Medicaid enrollment in the US by Congressional District.
This is the most serious threat that Adult Day Services and HCBS have ever faced. Please make phone calls and send emails today and every day until this crisis is averted!
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The following are tools and scripts which were shared by Justice in Aging and can be used and shared when calling your Congressional Representative and Senators to explain how harmful proposed Medicaid cuts will be to their constituents. Republican leaders in Congress are pushing forward legislation that would cut trillions in funding for Medicaid and other programs that older adults rely on to meet their basic needs. The budget resolution also includes deep cuts to SNAP benefits that would make it even harder for older adults to buy groceries.
To sign up for Justice in Aging training sessions and webinars, policy issue briefs, and news and policy changes, click here.
Script for Individual Congressional Representative/Senators Call
Script for State Organization Congressional Representatives/Senators Call
Issue Brief: How Medicaid Funding Caps Would Harm Older Adults
Families USA Medicaid Fact Sheet
Policy & Advocacy Updates
NADSA works with several national organizations who support care for seniors, veterans and adults with developmental disabilities. This page will feature current and ongoing activities NADSA is collaborating on with these national organizations.
AARP
- February 11, 2025 press release highlights poll results showing strong voter support for immediate action on a caregiver tax credit.
- January 7, 2025 letter from AARP sent to Congress to enact the Credit for Caring Act in any tax legislation advanced in the 119th Congress.
Better Medicare Alliance (BMA)
- February 20, 2025 letter to Stephanie Carlton, Acting Administrator advocating for the protection of the Medicare Advantage.
- February 10, 2025 letter to CMS Acting Administrator Stephanie Carlton providing comments on the Advance Notice
of Methodological Changes for CY 2026 for Medicare Advantage Capitation Rates and Part C and Part D Payment Policies. - January 27, 2025 letter and comments to Jeff Wu, Acting Administrator, The Centers for Medicare & Medicaid Services regarding the Contract
Year 2026 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs.
Leadership Council of Aging Organizations (LCAO)
- December 10, 2024 Chair’s letter from Leadership Council of Aging Organizations (LCAO) regarding the effort to achieve a budget before the end of 2024.
- January 22, 2025 LCAO letter to President Trump outlining eight key priorities for older Americans.
Modern Medicaid Alliance (MMA)
March 11, 2025: Facing the Potential of Federal Medicaid Cuts, State Governors Urge Caution
February 28, 2025:
- What They Are Saying: Protecting Millions of Americans & Their Medicaid Benefits
- Health Care Stakeholders Lead Widespread Opposition to Potential Medicaid Cuts
February 26, 2025: The Modern Medicaid Alliance (MMA) has issued a statement today following last night’s House of Representatives’ vote:
“The latest House vote breaks a vital promise to more than 70 million Americans who depend on the Medicaid program and now face the potential for unprecedented, destabilizing cuts to their coverage and access to care. The full extent of cuts being considered go far beyond addressing ‘waste, fraud and abuse’ and would undermine Medicaid coverage for those who depend on it. Already, Senators are issuing stark warnings about the impact of Medicaid cuts on the stability of their communities, state budgets, hospitals and providers. We urge members of the House and Senate to block any Medicaid cuts or harmful policy proposals as part of the ongoing budget process.”
Opposition to Medicaid Cuts Grows
NPR (March 10): Republicans say Medicaid cuts won’t happen. But does their budget work without them?
Democratic House Joint Leadership Letter (March 7): “House Democrats would enthusiastically support a bill that protects Social Security, Medicare, veterans health and Medicaid, but Republicans have chosen to put them on the chopping block to pay for billionaire tax cuts.”
Politico (Feb. 24): “Some Senate Republicans have begun pushing back against major cuts to Medicaid. Sen. Josh Hawley of Missouri, where more than 21 percent of the population is enrolled in Medicaid, told HuffPost he doesn’t support massive cuts to the program that House Republican leaders are weighing. Hawley joined Sen. Susan Collins (R-Maine) in the early hours of Friday morning in backing a Democratic amendment to the Senate budget resolution that would prevent tax cuts for the wealthy if any Medicaid funding is cut.”
HuffPost (Feb. 22): “‘Large cuts to Medicaid would hurt a lot of people in my state — and we voted overwhelmingly for President Trump,’ Sen. Shelley Moore Capito (R-W.Va.) said in an interview…”
Axios (Jan. 22): “Sen. Lisa Murkowski (R-Alaska), a key moderate vote who is not up for reelection, expressed the most concern about cuts. ‘I come from a state where Medicaid expansion has been really, really very key, so if it’s going to be part of reconciliation, [it’s something] I would be looking very critically at,’ she said.”
Here are social media resources you can use to communicate your concerns as well:
- Twitter/X: Proposed cuts to #Medicaid will jeopardize health coverage and increase costs for over 70 million Americans. As part of the budget reconciliation process, Congress must block the proposed cuts and protect Medicaid funding. Read @ModernMedicaid‘s statement: https://bit.ly/4hUvRhw
- Facebook/LinkedIn: Proposed cuts to #Medicaid will jeopardize health coverage and increase costs for over 70 million Americans. As part of the budget reconciliation process, Congress must block the proposed cuts and protect Medicaid funding. Read @Modern Medicaid Alliance‘s statement: https://bit.ly/4hUvRhw
February 14, 2025: Click on the following for several articles related to potential Medicaid funding cuts: Top Medicaid News
February 12, 2025: The Modern Medicaid Alliance released the following statement after the release of the proposed House Budget Resolution:
“Stable Medicaid funding is essential for the health and well-being of over 70 million Americans and the stability of local providers who care for them. Cuts to Medicaid would cause millions of Americans to lose access to care, destabilize rural hospitals and wreak havoc on state budgets. With seniors, veterans, and nearly half of our nation’s children depending on Medicaid, President Trump was right in promising to ‘love and cherish’ the Medicaid program. As budget legislation is considered, Medicaid should be supported and strengthened, not undermined with cuts and loss of coverage.”
February 7, 2025: The Modern Medicaid Alliance (MMA) released the following statement in response to the Senate Budget Committee’s release of its proposed budget resolution which indicates that Medicaid cuts are a possibility: https://modernmedicaid.org/pressrelease/mma-statement-on-proposed-senate-budget-resolution/
Medicaid Resources Spotlight
- Modern Medicaid Alliance’s Dashboard is linked here, with financial information included under “[State]’s Commitment to Medicaid” within each state page.
- National Rural Health Association Fact Sheet highlighting the Medicaid cuts impact on rural America
- Modern Medicaid Alliance Fact Sheet and Frequently Asked Questions
- Association for Community Affiliated Plans Medicaid Enrollment by Congressional District: https://communityplans.wpenginepowered.com/wp-content/uploads/2024/09/ACAP-The-Medicaid-Voter-2024.pdf
- Medicaid cuts could impact states’ credit ratings
- Federation of American Hospitals Medicaid Fact Sheet
- MMA Medicaid Dashboard: State-level Medicaid enrollment, funding, and polling data.
- Congressional District Health Dashboard: District-level Medicaid enrollment as % of total population (2024 Q1)
- Georgetown Center for Children and Families (CCF) Medicaid’s Role in Small Towns and Rural Areas: County-level Medicaid enrollment, with a focus on small town & rural county impact (2022-2023 ACS data)
- The Arc State-Specific Medicaid Fact Sheet: State-level one-pagers on Medicaid impact to key populations and state economy
National Council of State Legislatures
February 19, 2025: The National Council of State Legislatures issues a statement expressing concerns over federal Medicaid proposals: https://www.ncsl.org/resources/details/ncsl-joins-others-in-expressing-concerns-over-federal-medicaid-proposals