Federal Budget Law Raises Concerns for Older Adults

This summer, Congress passed and the President signed the One Big Beautiful Bill Act (OBBBA) on July 4, 2025—a sweeping federal budget reconciliation law that makes significant cuts and changes to Medicaid, SNAP (food assistance), and other safety net programs. The law has raised concerns nationwide for its potential impact on older adults, caregivers, and people with disabilities. 

Here in Washington, Area Agencies on Aging across the state continues to monitor the law’s implementation and what it could mean for the thousands of Washington residents who depend on these programs for daily living. 

 What the Law Does 

 The OBBBA includes several key provisions that affect access to long-term care, home- and community-based services, and food security. Among the most notable: 

• Medicaid Work Requirements: Beginning no later than Jan. 1, 2027, adults ages 19–64 will be required to work, attend school, or volunteer at least 80 hours per month to keep Medicaid coverage. While some exemptions apply (e.g., for pregnant individuals or full-time caregivers), others—such as older adults caring for aging spouses or grandchildren—may fall through the cracks. 
• Stricter Verification and Reporting Rules: Starting Jan. 1, 2027, states must conduct eligibility redeterminations for Medicaid every 6 months (instead of every 12 months) for those enrolled under the ACA expansion. States must also conduct quarterly checks using the SSA Death Master File and limit Medicaid retroactive coverage to 1–2 months. 
• Reduced Medicaid Funding: 
  • The 5% FMAP increase for new ACA expansion states will be eliminated Jan. 1, 2026. 
  • By Oct. 1, 2026, Washington may face reduced federal contributions to Medicaid, particularly related to changes affecting immigrant eligibility. 
• Tighter SNAP Rules: Upon enactment (July 4, 2025), the law expanded work requirements for SNAP to apply to beneficiaries up to age 64 (previously 54) and restricted eligibility for legal immigrants. These changes are effective immediately, though implementation may require further rulemaking. 
• Immigrant Eligibility Restrictions: As of Oct. 1, 2026, Medicaid and Medicare eligibility will be limited to lawful permanent residents, certain Cuban and Haitian immigrants, and those from Compact of Free Association countries. Others will be disenrolled by Jan. 4, 2027. 

 What This Could Mean for King County 

 For many older adults in our region, Medicaid and SNAP are lifelines. These programs help cover the cost of prescription drugs, in-home caregivers, transportation, meals, and basic needs. The new requirements and funding reductions could: 

• Lead to coverage losses for older adults and caregivers who cannot meet strict work or reporting rules. 
• Strain an already limited network of paid caregivers. 
• Reduce the availability of community-based services that help people age in place. 

 Our local aging network—including case managers, service providers, and advocates—is concerned about the possibility of service disruptions and increased barriers for those most in need. 

 What You Can Do 

Area Agencies on Aging will continue to follow this issue and communicate with federal lawmakers about its impacts. You can help by: 

• Sharing your personal story—Have these programs helped you or someone you care for? Stories help policymakers understand the real-life impact of their decisions. 
• Contacting your members of Congress—Let them know how important Medicaid, Medicare, and SNAP are in your life or community. 
• Staying informed—We’ll continue to provide updates as the law is implemented. 

 We know that programs like Medicaid and SNAP are not just budget line items—they are essential to health, safety, and independence for older adults and people with disabilities. 

Contributor Cathy Knight is State Director for the Washington Association of Area Agencies on Aging (W4A). Learn more at AgingWashington.org.