By Lynn Kellogg
“The budget reconciliation act (H.R. 1)—formerly named the “One Big Beautiful Bill Act” or OBBBA—was signed into law on July 4, 2025. It cuts over a trillion dollars from Medicaid, Medicare, and the Affordable Care Act (ACA).” Implementation is planned after the mid-term elections.
The quote above is from Justice in Aging, a national organization that uses the power of law to fight senior poverty by securing access to affordable health care. They predict that if implemented as planned, “…between 7.5 million and 10 million low income people are projected to have their Medicaid coverage taken away and 15 million people will become uninsured.”
This is not good. We’re in danger of serious over-simplification of complex issues, with everyday people, health systems and professionals caught in the aftermath.
Medicaid helps low-income seniors pay their Medicare Part B insurance premium, which covers doctor visits, so treatable conditions can be addressed before causing unnecessary decline and high-cost emergency room and hospital stays.
Medicaid waivers, called MI Choice in Michigan, provide adults aged 18 and older who need nursing home care, a chance to have that care delivered in their home. It’s a win-win proposition. People are happier, costs are roughly half the cost of a nursing home. Medicaid is the funder, though eligibility is unique for this program. Try it – thousands in Southwest Michigan have benefited.
Likewise in Medicare, innovations result in better care, lower cost. For example, years ago Medicare allowed hospice care as an innovation avoiding unnecessary end of life hospitalizations. Now, insurance innovations for folks who are low-income and older, eligible for both Medicaid and Medicare, coordinate care between the programs with terrific outcomes. Also, the GUIDE model is a Medicare innovation for dementia care, piloted locally by Area Agency on Aging.
It is difficult to stay current. Fortunately, when it comes to navigating Medicare, Medicaid and the Affordable Care Act for oneself or loved ones, we have a local gem of objective information, the local Area Agency on Aging {AAA).
AAA is part of a nationwide network of entities designated by Older Americans Act (OAA) to plan and develop programs, services and businesses so people from all walks of life have the information and choices they need to age with dignity and maximum independence possible. The OAA is the backbone of aging service development across the country.
As a result of understanding how policy and law affect successful aging, and hearing directly from consumers what their needs are, AAA has historically been in the forefront of demonstrations and innovations to make Medicaid and Medicare more impactful and efficient.
AAA also participates in a national Medicare effort using well trained volunteer counselors to advise and help individuals understand Medicare and Medicaid choices. Counselors can also help review your Medicare supplemental needs, apply to Medicaid or a Medical Savings Program, identify and report Medicare and Medicaid fraud and scams, and more. Counselors are active at AAA’s offices at 2900 Lakeview Ave. in St. Joseph, and nine locations across Southwest Michigan, saving millions for local residents.
There are other great things going on. For example, AAA’s Integrated Care At Home provides home-based medical care: Primary Care, Behavioral Health Counseling, Chronic Care Management, and Nutrition Counseling. Available to adults 18 and older who would benefit from home-based care. The program is designed to lessen emergency room visits and hospitalizations and bring health to where it happens – home.
Additionally: Transition Services help persons return home from a nursing home; Custom Care private pay assistance can be tailored to family needs; GUIDE – the Medicare demonstration helps in dementia care, and on and on. Too much to mention here. Go to www.AreaAgencyonAging.org and check out Program & Services and explore. You’ll be amazed.
An adult daughter whose mom moved into a nursing home before she knew her options commented, “I had no idea where to turn. Region IV Area Agency helped my mom move home again. What a blessing!“
Don’t hesitate, call the professionals on the Info-Line for Aging and Disability at 1-800-654-2810 to learn more. No cost, no obligation, great information.
Lynn Kellogg is former CEO of Region IV Area Agency on Aging in Southwest Michigan. Questions on age or independence services? Call the Info-Line for Aging & Disability at 800-654-2810 or visit areaagencyonaging.org. The Generations column appears each weekend in The Herald-Palladium.