Could $1 Trillion in Medicaid Cuts Leave 16 Million Uninsured? Senate HELP Committee Wants Your Take

With sweeping cuts to Medicaid looming under the proposed One Big Beautiful Bill Act, the Senate Health, Education, Labor and Pensions (HELP) Committee is asking providers to weigh in on what those reductions would mean for their operations.

Sen. Bernie Sanders (I-VT), the committee’s ranking member, has sent a detailed questionnaire to a wide range of healthcare stakeholders—provider groups, community health centers, hospitals, rural health clinics and individual clinicians—seeking feedback on how the bill’s healthcare provisions would affect resident care, staffing choices and service availability.

In a pointed statement accompanying the request, Sanders condemned the GOP’s plan to push such a critical measure through without any expert hearings or testimony from those on the front lines of medical and caregiving services.

• Billions for Shareholders, Pennies for Patients? Yale Study Exposes Where U.S. Health Care Profits Really Go
• Trump Open to Medicaid Work Requirements Amid GOP Push for Spending Cuts
• Elevance Calms Wall Street Jitters After UnitedHealth Shake-Up

According to the committee’s news release, Sanders warned that the reconciliation package would slash federal healthcare spending by more than $1 trillion and strip 16 million Americans of their insurance—“turning the crisis in American healthcare into a national emergency.”

Drawing on research by Yale’s School of Public Health and Penn’s Leonard Davis Institute of Health Economics, he noted that the proposed cuts could lead to over 51,000 unnecessary deaths each year and drive up premiums for older adults.

LeadingAge, in its summary of HR 1 (the One Big Beautiful Bill), formally opposed the legislation, highlighting several policies that would disproportionately burden aging-services providers. For instance, moving Medicaid eligibility reviews from annual to biannual would overwhelm state systems and risk kicking older adults out of coverage due to administrative hurdles.

“The sum of these policies will result in reduced access, rates, services, benefits or all of the above,” LeadingAge warned, urging its members to submit comments by June 20.

The group also raised alarms about lowering the home-equity limit for long-term care eligibility, saying it could force low-income seniors—whose home is often their sole asset—to choose between giving up essential services or borrowing against their property.

Further concerns included restrictions on retroactive Medicaid and CHIP coverage, which could leave long-term care providers weighing whether to admit patients before approval (and risk financial loss) or limit new admissions—“creating a major access issue.”

Other provisions under scrutiny would tighten Medicare eligibility for some immigrant groups—potentially affecting direct-care workers and their families—and introduce cuts and tax moratoriums that could destabilize commercial insurance marketplaces.

The National Center for Assisted Living has labeled these proposed cuts “historic,” warning that optional services such as home- and community-based care would be first on the chopping block if states lose Medicaid dollars—alarming news for the roughly one-in-five assisted-living residents who rely on Medicaid.

Both Argentum and the American Seniors Housing Association have blasted the cuts as short-sighted, arguing they’d drive up overall costs and undermine care quality, while stripping away Medicaid waivers that help older adults stay in assisted-living communities.

Throughout the budget reconciliation debate, the senior-living sector rallied around a “protect Medicaid” mantra—now providers have until June 20 to tell the Senate HELP Committee exactly what’s at stake.