NY’s Senator Blasts Plan To Cut VA Workers, Cut Medicaid, Demand Answers On Withholding Critical Infrastructure Funds, Honors Hazel Dukes Of NAACP After Her Passing, Praises Longtime Staffer Geri Shapiro

NY’s Senator Blasts Plan To Cut VA Workers, Cut Medicaid, Demand Answers On Withholding Critical Infrastructure Funds, Honors Hazel Dukes Of NAACP After Her Passing, Praises Longtime Staffer Geri Shapiro

Editor’s note: Senator Gillibrand has been a staunch supporter of veterans, first responders, senior citizens, women, and marginalized groups for her entire political career.  She participated in recent legislation to protect the rights of workers to unionize and collectively bargain.  You can also see her press conference in response to the announcement of the ratification of the 28th Amendment (also known as the Equal Rights Amendment, protecting women from discrimination on the basis of sex) by President Biden just before he left office. We recently interviewed an attorney about this amendment, which will be published in the next couple of weeks. She called on the Senate to pass the bipartisan bill that expands social security benefits and the CHIPS Act funding which brings good-paying IT jobs to Upstate New York.   Senator Gillibrand, along with State Senator Scarcella-Spanton, also hosted a Veterans’ Roundtable to discuss with the affected individuals traumatic brain injuries, and how they have harmed the health of many veterans (usually from firing their own weapons)  

Also, according to KFF, “200% of poverty: In 2022, nearly three in 10 (29.4%, or 17.0 million) adults ages 65 and older had incomes below 200% of poverty under the official measure ($28,080 in 2022). The share is higher – more than four in 10 (42.2%) older adults, or 24.4 million people – based on the Supplemental Poverty Measure.” For context, the federal poverty level for ALL 50 states, including New York, where the cost of living is higher, is about $15,000 for a single person.  So, 200% of the poverty level is about $30,000.  Rent alone in New York City costs more than that in most locations.  Apartments.com places the average rent in NYC at $3,923 per month, or $47,076 per year. 

GILLIBRAND BLASTS TRUMP PLAN TO GUT THE VA, STRIP HEALTH CARE FROM VETERANS

New York State Is Home To 662,000 Veterans, The Eighth-Largest Veteran Population In The Country

Massive And Arbitrary Cuts Will Prevent Our Vets From Receiving The Health Care and Benefits They Have Earned

Trump’s Plan Could Lead to the Firing of 18,000 Nurses, Over 30% of the Veterans Benefits Administration

WASHINGTON, D.C. – Today, U.S. Senator Kirsten Gillibrand held a virtual press conference blasting the Trump administration’s plan to fire more than 80,000 VA employees — roughly 20,000 of whom are veterans themselves – and to push back against the administration’s blatantly dishonest claim that these cuts will not affect veterans’ ability to access health care and receive the benefits they are owed. The administration has not shared details with Congress regarding who exactly will be fired, what they do, or where they work. Taking an axe to arbitrarily reduce the VA workforce as we’ve seen the administration do to other agencies would mean that VA Medical Centers in New York could be left decimated, and veterans could be left with nowhere to turn.

“President Trump and Elon Musk claim that gutting the VA won’t hurt veterans. They are lying,” said Senator Gillibrand. “He is firing tens of thousands of the people making sure veterans are getting the benefits they have earned, the people who work to combat veteran suicide and homelessness, and the nurses who treat veterans with health issues from their service. This is a despicable plan that will devastate veterans. It is a betrayal of the men and women who have served our country, and I will do everything I can to fight it.”

The full text of Senator Gillibrand’s letter to Secretary of Veterans Affairs Doug Collins is available here or below: 

We write today regarding a memo issued by your Chief of Staff on March 4, and later proudly announced by you via Twitter, detailing a plan to reduce the Department of Veterans Affairs (VA) workforce to 2019 levels. Over the past five years, there have been monumental bipartisan expansions and improvements to veterans’ healthcare and benefits. Your proposal puts all of them at risk. And we believe it is blatantly dishonest to claim veterans’ healthcare and benefits will not be impacted by the termination of up to 83,000 employees, including 20,000 veterans.

Since 2019, through the PACT Act, VA has implemented the largest expansion of eligibility for earned care and benefits to veterans and their families in decades. Congress has also worked in a bipartisan manner to provide critical funds and tools for VA to work more closely with states and local organizations to address veteran suicide and veteran homelessness through the Commander John Scott Hannon Veterans Mental Health Care Improvement Act (Public Law 116-171). And we have worked with the Department to develop policy to further address veterans’ mental health care needs in the Sgt. Ketchum Rural Veterans Mental Health Act (Public Law 117-21), the COMPACT Act (Public Law 116-214), and the REACH Act (included in Public Law 117-328).

Additionally, the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020 (Public Law 116-315) made massive improvements to women veterans’ health care through the Deborah Sampson Act, improved veterans’ timely access to health care, established greater outreach and engagement with Native Veterans, and streamlined veterans’ access to earned disability benefits online. The Joseph Maxwell Cleland and Robert Joseph Dole Memorial Veterans Benefits and Health Care Improvement Act (included in Public Law 117-328) improved access to care for rural veterans, bolstered services for aging veterans, and expanded programs for veterans experiencing or at risk of homelessness. And the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act (Public Law 118-210) gave VA tools to hire additional highly-skilled physicians, serve additional veterans experiencing homelessness, expand access to dental care, improve the Program of Comprehensive Assistance for Family Caregivers, establish a pilot program for assisted living for veterans, and more. To support the proper implementation and execution of these laws, Congress worked in a bipartisan and bicameral manner to increase appropriations while VA bolstered its capacity to deliver for veterans, including hiring thousands of additional staff. Your choice to unilaterally cut staff and redistribute associated funds will unquestionably harm veterans and is in direct opposition of Congressional intent.

Reducing VA’s workforce to 2019 levels will reverse the progress made since that time, including a 16 percent increase in outpatient visits and a 23 percent increase in veterans and survivors receiving disability compensation benefits, as well as additional investments in critical bipartisan priorities such as a 50 percent increase for mental health care, an 85 percent increase for caregiver support, and a 66 percent increase for cemeteries and memorial benefits. Fewer staff to provide outpatient appointments will cause veterans to wait longer for care, and the costs of that care will only increase over time as their medical conditions worsen. Reductions in mental health care will undoubtedly leave more veterans abandoned as they attempt to overcome the invisible wounds of war. Rolling back caregiver support will result in more veterans placed in long-term care, at a much greater cost to the Department and severely limiting quality of life for them and their families. Since VA’s solemn mission is to serve veterans and put them first, we would like to see evidence of how these cuts will impact the 20,000 veterans – making up 25 percent of the approximately 80,000 employees to be cut – you plan to terminate, as well as and the millions of veterans they served.

As we continue to first learn of these disastrous ideas from VA employees and veterans, we will continue to speak out and fight on behalf of those men and women unjustly and immorally harmed by your actions. We are not deterred or fooled by your political theatrics that seek to defend your actions with half-truths and vague, empty promises – and neither are veterans. We will make sure the public knows the truth – that cutting back to 2019 staffing levels means firing over 18,000 nurses, ten percent of the VA police force, nearly 10,000 schedulers, and more than thirty percent of the Veterans Benefits Administration staff. And we will continue to share the stories of veterans you have fired who served their country for decades, were honorably discharged, and had stellar performance reviews while working at VA – before you callously and illegally terminated them.

We urge you to start putting veterans first – to review VA’s own data, listen to your leadership and frontline staff on the ground serving veterans every day, and talk to veterans and their families. When you do, you will come to the one and only legitimate conclusion – that massive, arbitrary staff cuts will not make the Department more efficient nor improve care and benefits for veterans. In fact, they will have the opposite effect, and they will dishonor the contract the United States made with these veterans when they signed up to risk their lives in service to our nation.

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GILLIBRAND, CLYBURN, MURRAY, DELAURO DEMAND ANSWERS ON TRUMP ADMINISTRATION WITHHOLDING FUNDS FOR FEDERAL INFRASTRUCTURE PROJECTS, FIRING CRITICAL SAFETY WORKERS

WASHINGTON, D.C. – U.S. Senator Kirsten Gillibrand, ranking member of the Senate Appropriations Subcommittee on Transportation, Housing and Urban Development, and Related Agencies; Representative Jim Clyburn, ranking member of the House Appropriations Subcommittee on Transportation, Housing and Urban Development, and Related Agencies; U.S. Senator Patty Murray, vice chair of the Senate Appropriations Committee; and Representative Rosa DeLauro, ranking member of the House Appropriations Committee, are demanding answers from the Department of Transportation on actions it has taken to withhold funding from the Infrastructure Investment and Jobs Act (IIJA) and the annual Transportation, Housing and Urban Development, and Related Agencies Appropriations Acts (THUD).

The department has paused at least an estimated $60 billion in competitive grants for critical transportation projects that were awarded to rural, suburban, urban, and Tribal communities across the country. This is causing unnecessary delays in carrying out much-needed highway, bridge, transit, airport, port, and rail safety and improvement projects. The administration has also moved to swiftly and arbitrarily downsize the department’s workforce, with no regard to how this will affect agency operations and the transportation programs communities rely upon. The members are concerned that the department has provided no details on staffing reductions and has terminated probationary employees that support safety functions.

“We write today about recent funding, policy, and staffing changes at the U.S. Department of Transportation (DOT) that could impede the headway we have made in improving our nation’s infrastructure,” wrote the members. “The bipartisan IIJA and THUD Acts are making tremendous progress in improving our nation’s highways, bridges, transit systems, rail networks, and ports. The backlog of capital improvements for our airport runways and terminals, subways, and railways requires we continue to commit and unlock the combined resources made available through these bills, as intended by Congress. We are concerned by the actions the department has taken to withhold these funds and delay implementation of critical infrastructure projects throughout the country.”

The full text of Gillibrand, Clyburn, Murray, and DeLauro’s letter to Secretary Duffy is available here or below:

Dear Secretary Duffy:

We write today about recent funding, policy, and staffing changes at the U.S. Department of Transportation (DOT) that could impede the headway we have made in improving our nation’s infrastructure since Congress passed the bipartisan Infrastructure Investment and Jobs Act (IIJA), as well as the annual Transportation, Housing and Urban Development, and Related Agencies Appropriations Acts (THUD). The American Society of Civil Engineers’ (ASCE) most recent report gave U.S. infrastructure an overall “C-minus”, with 43 percent of our public roadways in poor or mediocre condition. Yet, this is an improvement; it took this country more than 20 years just to get out of the “D” range. In order to bring our transportation into a state of good repair, ASCE estimates that $2.59 trillion is required over 10 years. The IIJA and THUD Acts are making tremendous progress in improving our nation’s highways, bridges, transit systems, rail networks, and ports, and the backlog of capital improvements for our airport runways and terminals, subways, and railways requires we continue to commit and unlock the combined resources made available through these bills, as intended by Congress. We are concerned by the actions the Department has taken to withhold these funds and delay implementation of critical infrastructure projects throughout the country.

As leaders of the Senate and House Committees on Appropriations, we are particularly attuned to the funding, as well as staffing, needs of the Department. In order to increase transparency and ensure the Committees can conduct proper oversight of the Department and Congressionally appropriated funding, we respectfully request that you respond to the following questions no later than March 19, 2025.

Competitive Discretionary Grants

The Department has paused at least an estimated $60 billion in competitive grants that were awarded but have not yet been obligated, which is causing unnecessary delays in carrying out much needed infrastructure and safety improvement projects in rural, suburban, urban, and Tribal communities throughout the country. States, cities, towns, counties, Tribes, Metropolitan Planning Organizations, port authorities, transit agencies, airports, and more developed complex funding plans that include the competitive grant funding they have already been awarded.

According to a recent Departmental Memorandum titled “Implementation of Executive Orders Addressing Energy, Climate Change, Diversity, and Gender”, these competitive grants are being reviewed to determine compliance with recent Executive Orders. Despite the Administration’s claims of transparency and accountability, the Department has provided few specifics on the process for this review, and state and local transportation agencies, as well as the Senate and House Committees on Appropriations that deliberately appropriated these funds, are appealing for more transparency and clarity.

1. The Departmental Memorandum requires all DOT Operating Administrations (OAs) and all components of the Office of the Secretary (OST) to identify and list in a written report “all DOT orders, directives, rules, regulations, notices, guidance documents, funding agreements, programs, and policy statements” that are subject to recent Executive Orders within 10 days of the memorandum’s issuance (by February 8, 2025) and requires that within 10 days of submission of these reports, the OAs and OST initiate all “lawful actions necessary to rescind, cancel, revoke, and terminate” such things (by February 18, 2025). Please provide the list of all DOT funding agreements and programs that were identified as being subject to the Executive Orders as well as those that DOT has rescinded, cancelled, revoked, or terminated.
2. Please explain the step-by-step process by which DOT and/or the modal administrations are reviewing awarded and announced competitive grants that are currently unobligated.
3. Has the Department proactively notified every grantee impacted by this DOT Memorandum since the review was initiated?
4. Who within the Department and/or the modal administrations is conducting the review of these competitive grant awards?
5. Has the Department completed the review required in the DOT Memorandum for any competitive grant awards to date? If so, how many grants have been approved and moved to obligation and how many have been denied?
6. Competitive grant programs administered by DOT are authorized in statute through legislation, like the IIJA, or through specific terms and conditions included in THUD Acts. Please provide the Department’s legal analysis on whether, and if so, how, the Executive Orders can supersede statute for competitive grant programs.

Workforce

Successful and efficient implementation of funding for all modes of transportation requires robust staffing across the Department to ensure projects are completed on time and on budget. Yet the administrative actions to swiftly and arbitrarily downsize the Department’s workforce seemingly have no regard to how this will impact agency operations and communication with grantees, how experienced and exemplary employees will be maintained, nor is it consistent with the most recent budget requests or specific salaries and expenses directed by the Senate and House Committees on Appropriations. We appreciate the Department’s efforts to exempt some critical safety positions from recent employment actions, however, we remain concerned that the Department has terminated probationary employees that support safety functions at some modal administrations. Further, based on the list of exempted positions provided by the Department to the Senate and House Committees on Appropriations, no safety related positions at the Federal Transit Administration or National Highway Traffic Safety Administration have been exempted.

In addition, U.S. District Judge William Alsup has since blocked the mass firing of probationary employees by the U.S. Office of Personnel Management (OPM) and has ordered OPM to rescind its directives.

According to your own recent statements, hundreds of probationary employees have been terminated by the Department, and this figure could be in the thousands since you became Secretary when considering the Administration’s deferred resignation program. To date, the Department has not provided the Senate and House Committees on Appropriations details on any staffing reductions through probationary terminations or deferred resignation nor how the vital ongoing work at the Department will not be impeded by these actions.

1. Please provide the total number of employees by position that accepted the “Fork in The Road” deferred resignation program by modal administration, office, funding source, and city and state of their duty station.
2. For the employees who have accepted the deferred resignation program, what is the estimated cost to pay those employees for not working through the end of the fiscal year?
3. Please provide the total number of probationary employees by position that were terminated by modal administration, office, funding source, and city and state of their duty station.
4. What factors did the Department and/or modal administrations consider when determining which employee positions were exempt from recent employment actions?
5. Please explain the steps the Department and/or modal administrations took to ensure the continuity of DOT programs with a reduced workforce.
6. Please provide the total number of employees by position who have been placed on administrative leave or have been terminated as a result of the Executive Order 14151 titled “Ending Radical And Wasteful Government DEI Programs And Preferencing” by modal administration, office, funding source, and city and state of their duty station.
7. Please provide information on how the Department plans to implement the Executive Order 14210 titled “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative” and the expected timeline for additional employee actions as a result of this Executive Order.
8. As required by Executive Order 14210, please provide DOT’s comprehensive list of the functions performed by each modal administration that are mandated by statute or related to public safety and law enforcement, as well as the current number of staff associated with those functions.4
9. The Committees provide funding for the operations of the modal administrations, taking into account specific staffing needs in each office, to support the Department’s mission. How are the costs of the deferred resignation program, probationary employee terminations, and potential additional reductions in force “necessary expenses” consistent with appropriation law?

Lastly, we remind you of the Department’s obligations under appropriations law to consult with the Senate and House Committees on Appropriations, which craft the annual appropriations acts on a bipartisan basis, and to ensure all actions taken by the Department are consistent with section 405 of the Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2024 (Public Law 118-42), which remains in effect today under the Further Continuing Appropriations Act, 2025 (Public Law 118-158). In addition, section 739 of the Financial Services and General Government Appropriations Act, 2024 (Public Law 118-47), which also remains in effect under Public Law 118-158, prohibits the Department from eliminating or reducing funding for a program or project unless such change is made pursuant to reprogramming provisions, including section 405 of Public Law 118-42.

We appreciate your prompt response to these concerns.

WATCH: GILLIBRAND DELIVERS FLOOR SPEECH HONORING DR. HAZEL DUKES

Dr. Dukes was the president of the NAACP New York State Conference and a longtime advocate and activist

WASHINGTON, DC – Today, U.S. Senator Kirsten Gillibrand delivered a speech on the Senate floor to honor Dr. Hazel Dukes, longtime president of the National Association for the Advancement of Colored People (NAACP) New York Conference and former national president of the NAACP, who passed away earlier this month.

Speech Text:

1. President,

I want to take a moment to honor the late Dr. Hazel Dukes, who died earlier this month. Hazel was not just my mentor and longtime friend — she was an extraordinary advocate for members of the African American community across New York.

When I was first appointed to the Senate, Hazel took me under her wing. She helped me learn how to do my job well and how to serve my constituents effectively.

Hazel was a wise and generous soul. She was a trailblazer for the civil rights movement and the longstanding president of the New York State NAACP. She fought housing discrimination on Long Island and was a tireless advocate for equal educational opportunities. Hazel’s leadership shaped the NAACP and she inspired future generations nationwide.

Hazel was truly a treasure, and I was devastated to learn of her passing. Her legacy will live on in the fight for justice she waged and the lives she changed. May we honor her by continuing the work she so fiercely championed.

Hazel, we miss you very much, and we will always remember you.

WATCH: GILLIBRAND DELIVERS FLOOR SPEECH HONORING LONGTIME STAFFER GERI SHAPIRO

Shapiro is a Westchester County Native and a Go-To Resource for Advocates, Staffers, and Constituents on Issues Related to Aging and Indian Point

WASHINGTON, DC – Today, U.S. Senator Kirsten Gillibrand spoke on the Senate floor to honor her longtime staffer Geri Shapiro, who is one of the oldest members of staff in Congress.

** WATCH GILLIBRAND’S SPEECH ON THE SENATE FLOOR HERE or below**

Speech Text:

1. President,

Today, I want to tell you about an extraordinary woman, my senior advisor Geri Shapiro. Geri is in the final stages of a long battle with cancer and so I wanted to express my deepest gratitude and thank her for her service to my office and New York.

Geri joined my staff in 2009 after she served as Hillary Clinton’s Westchester Regional Director. But she’s so much more than a member of my staff. She is one of my closest confidants, mentors, and friends. She is truly one of a kind.

Geri is an institution in Westchester, New York. She knows everybody and everybody knows her name. Everyone who knows her knows that when Geri gives her word, it’s as good as gold.

She’s an expert in so many important areas of policymaking, and the depth of knowledge she brings to any conversation is as impressive as her ability to make people feel at ease. My staff – most of whom are decades younger – adore her energy and spirit.

Geri is one of the kindest people you’ll ever meet, and she cares deeply about her fellow New Yorkers.

But don’t let that fool you. She’s also as tough as nails.

Geri tells it like it is and doesn’t pull punches. She’s fearless and formidable, and her family calls her the “expeditor” because she gets things done. With Geri on your side, you know you can’t lose.

A longtime Westchester resident who grew up in New Rochelle, Geri’s first career was as a homemaker and mom, and she devoted much of her time to caring for her aging parents. During that time, she took courses at Columbia University and became a stockbroker to support her ailing father’s business. She also volunteered at her daughter Leslie’s school where she served as Edgemont PTA president.

In 2000, Geri was inspired to volunteer on Hillary Clinton’s Senate campaign because she admired Hillary’s passion for health care.

Hillary immediately recognized Geri’s talents and hired her as her Westchester Regional Director when Geri was 59 years old! In Geri’s own words, it gave a whole new meaning to the term “late bloomer,” and she credits Hillary’s younger staffers for helping her learn the ropes.

To this day, Geri is among the oldest members of staff in Congress. She is proof positive that you can do amazing things at any age.

I first met Geri when I also volunteered on Hillary’s Senate campaign. When I became senator, I asked her to serve as my Westchester County expert. I remember meeting her at the train stop in Westchester early in my Senate tenure and knowing then and there that she would be a friend for life.

Since then, Geri has led our community outreach in Westchester and has become a deeply valued member of our team.

She is my go-to expert when it comes to anything related to the Indian Point nuclear facility. She knows the ins and outs of policymaking and procedure better than most, and she’s become an invaluable resource for people working on nuclear energy regulation, especially with the Nuclear Regulatory Commission and its Indian Point decommissioning process.

But if it’s not nuclear policy, it’s something just as important, like her leadership on my Aging Working Group or her work with health care and disability advocates. Geri understands the substance of the work, and she knows how to channel her own experiences into bigger causes. But what really sets her apart is that she understands how much relationships matter. Whether you’re a neighbor, a CEO, a friend, or a high-ranking official, Geri is the first person you turn to. Her instincts are spot-on.

She connects with people in a way few others can, and she always brings a human touch to everything we do.

She mentors my staff on the importance of public service and the power of grassroots organizing. She emphasizes what it means to connect with a community and to understand the needs of our constituents. She gives everything her full attention and effort and leads by example in everything she does. She clearly sees her work not just as a job, but as a real calling.

Throughout my entire Senate career, Geri has not only been an outstanding strategic and political advisor but also a dear friend. She gives me heartfelt advice when I need it most and shows thoughtfulness and generosity to everyone who knows her. She is hard-working, caring, and the most dedicated Senate staffer that I know by her years served and service given.

When Geri speaks, people listen— and when she gives advice, you know it comes from a place of deep knowledge and careful thought. New York and this nation need more leaders like her.

When asked what motivates her, Geri says, “Do good, feel good” — a maxim that is evident in everything she’s done.

She is truly an inspiration to everyone who knows her, and I am so grateful for everything she’s done for Westchester and our state.

Thank you, Geri. We love you. And we will always remember you.

GILLIBRAND, WYDEN SLAM REPUBLICAN EFFORTS TO SLASH MEDICAID BY HUNDREDS OF BILLIONS, CALL ON TRUMP ADMINISTRATION TO PROVIDE ANSWERS ON FULL IMPACT TO OLDER AMERICANS

WASHINGTON, D.C. – Today, U.S. Senators Kirsten Gillibrand, ranking member of the Senate Aging Committee, and Ron Wyden, ranking member of the Senate Finance Committee, led a group of 14 senators to demand answers on Republican efforts to slash Medicaid funding by hundreds of billions of dollars. The potential cuts would be devastating for the millions of older Americans and their families who rely on the program, denying them access to lifesaving health care as well as long-term care. Gillibrand and Wyden are calling on Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. to detail what – if any – plan the Trump administration has to provide care for seniors after gutting Medicaid.

“We are writing today to express our grave concerns regarding Republican efforts to gut the Medicaid program. We are particularly concerned with how these cuts will negatively impact the millions of older Americans and their families who rely on the program for lifesaving care,” wrote the senators. “Republicans claim that they are committed to protecting the interests of older adults, yet their efforts, with the support of the Trump administration, to cut hundreds of billions of dollars from the Medicaid program run antithetical to such a promise and will shatter the lives of millions of older Americans. We request that you address how the Trump administration plans to rectify the extensive consequences if proposed cuts were to be enacted.”

The letter was also signed by Senators Raphael Warnock (D-GA), Richard Blumenthal (D-CT), Peter Welch (D-VT), Angela Alsobrooks (D-MD), Tina Smith (D-MN), Adam Schiff (D-CA), Amy Klobuchar (D-MN), Tammy Duckworth (D-IL), Elizabeth Warren (D-MA), Jeff Merkley (D-OR), Cory Booker (D-NJ), and Jack Reed (D-RI).

The full text of Senators Gillibrand and Wyden’s letter to Secretary Kennedy is available here or below: 

Dear Secretary Kennedy,

We are writing today to express our grave concerns regarding Republican efforts to gut the Medicaid program. We are particularly concerned with how these cuts will negatively impact the millions of older Americans and their families who rely on the program for lifesaving care. Republicans claim that they are committed to protecting the interests of older adults, yet their efforts, with the support of the Trump Administration, to cut hundreds of billions of dollars from the Medicaid program run antithetical to such promise and will shatter the lives of millions of older Americans.

By cutting Medicaid, millions of older adults will no longer have access to the care they need to address chronic diseases, prevent conditions that balloon health care costs, and provide long-term care services and supports. By cutting older adults off from Medicaid-funded health and social interventions, many seniors will not be able to obtain the life-sustaining services they need and will spiral into illness and poverty.

We are particularly concerned about the following consequences:

Without Medicaid, older adults will lose access to long-term services and supports and unpaid family caregivers will shoulder an even greater responsibility. Medicaid is the primary payer of long-term services and supports in the United States. That includes people who are cared for in their homes by home health providers and other paid caregivers and those in nursing facilities. Without Medicaid, millions of Americans who need long-term services will have nowhere to turn, except to their family members who may need to reduce their work hours or quit their jobs altogether, causing significant harm to their family’s financial health and the financial health of their communities. The consequences will be even far more dire for the many seniors who age alone without family caregivers—with nowhere to turn, draconian Medicaid cuts that push seniors off Medicaid may force many into homelessness.

Reduced access to primary care through Medicaid will balloon health care costs for the nation and the Medicare program. Medicaid has enabled over 72 million Americans to access health care, much of which is preventative primary care. Primary care is the foundation of good health, preventing exacerbation of chronic diseases that lead to costly hospital admissions. Without Medicaid coverage, many will wait until their health conditions worsen and access more costly care through the emergency department. Medicaid cuts will create needless suffering and increase hospitals’ uncompensated care costs, jeopardizing hospital financial stability.

Cuts to Medicaid will disproportionately affect dually-eligible seniors, who are often the sickest and most in-need of care. Many seniors who are eligible for both Medicare and Medicaid coverage have complex health and social needs. It is critical that health care is accessible and comprehensive for this population. For many dual-eligible beneficiaries, Medicaid assists seniors with their Medicare co-pays through the Medicare Savings Program, so a cut to Medicaid equates to a cut to Medicare. Without this cost-sharing assistance from Medicaid, many seniors will be unable to afford health care at all. Dual-eligibility also opens up options for participation in integrated care models, such as dual eligible special needs plans (D-SNPs) and Program of All-Inclusive Care for the Elderly (PACE), which increases care coordination and improves outcomes for seniors.

Instead of investing in upstream health interventions through Medicaid, the proposed cuts will increase health care spending on preventable causes. Medicaid programs also address social factors that contribute to poor health, such as lack of food, housing insecurity, and rural geography. Decades of evidence demonstrate the power of these social factors to negatively impact one’s health. Addressing social and structural determinants of health is not a woke agenda; it is evidence-based science. Such programs will benefit older Americans of all races, ethnicities, and political leaning; for example, lack of transportation to rural health care facilities is a social determinant addressed by many Medicaid programs. Cuts to these upstream interventions will result in a sick nation and hundreds of millions of dollars spent on medical care for preventable causes.

We request that you address how the Trump administration plans to rectify the extensive consequences detailed above if proposed cuts were to be enacted. Specifically, please respond to the following questions:

1. Provide an estimate of how many individuals will lose access to long-term care services and supports, in both facility and home and community-based services settings, as a result of the proposed Medicaid cuts.
2. Knowing that Medicare does not cover long-term care services and supports and private market alternatives are inadequate and often too expensive, what alternatives does the Trump Administration plan to  provide to older adults who will no longer have access to long-term care services and supports through Medicaid?
3. Please detail how these alternatives will be made accessible to older adults of all incomes.
4. How does the Administration plan to support the individuals forced to leave jobs or reduce their hours to care for family members?
5. How does the Administration propose we care for older adults without available family caregivers (kin or non-kin) if they were to lose access to their long-term care services and supports through Medicaid?
6. How would the Administration ensure dually-eligible seniors are able to afford Medicare premiums and copays to access the health care they critically need if they no longer have access to Medicaid? What alternatives do you propose to ensure that these seniors with high-need, medically complex health issues do to access health services?

Please respond by Friday, March 21.

Banner Image: Senator Gillibrand and Hazel Dukes. Image Credit – Senator Gillibrand

Senator Kirsten Gillibrand