Medicaid serves as a lifeline for millions of older adults, people with disabilities, and low-income individuals, providing essential healthcare services, long-term care, and financial protection. Yet, recent policy proposals threaten to introduce bureaucratic barriers and funding cuts that could strip many of these individuals of their access to care.
The work of Dr. Julie Robison, a professor at the UConn Center on Aging, and clinical research associates Alba Siharath Santiago and Deb Migneault, emphasizes the urgency of these policy changes and the devastating impact they could have—especially on LGBTQ+ older adults, disabled individuals, and rural residents in Connecticut.
The Stakes for Connecticut Residents
Medicaid is the primary funder of long-term care in the U.S., covering nursing homes, home health aides, and essential in-home support for those who can no longer fully care for themselves. According to research from the UCONN Center on Aging, nearly 1 in 4 Medicaid enrollees qualify due to age or disability, many of whom have no other financial means to pay for care.
Proposed Medicaid funding cuts, block grants, and work requirements could strip millions of vulnerable people of these services, resulting in:
Loss of basic living supports like help with bathing, dressing, and eating.
Increased financial hardship for older adults and disabled individuals who have no other way to pay for care after exhausting their savings.
Higher rates of hospitalizations and emergency care needs, particularly in rural communities where hospitals already struggle to stay open.
Dr. Robison warns, “Cuts to Medicaid will put older adults and people with disabilities in jeopardy, leaving them without critical long-term care and services.”
The Impact on LGBTQ+ Older Adults
For older LGBTQ+ adults, Medicaid services are about more than just healthcare—they are about dignity, safety, and survival. Many LGBTQ+ elders have lived through decades of discrimination, making them less likely to have traditional support systems such as spouses or children to care for them in old age.
Medicaid-funded long-term care allows many to stay in their homes longer or receive support in facilities. However, Dr. Robison highlights a troubling reality:
“Older LGBTQ+ adults receiving care through Medicaid at home or in nursing homes frequently report having to hide family photos or other personal items because they are afraid service providers will discriminate against them.”
Without Medicaid’s protections, many LGBTQ+ seniors face the double burden of discrimination and financial instability as they seek essential care.
Alba Siharath Santiago, who works directly with older adults, underscores the urgency of protecting Medicaid access:
“For many older LGBTQ+ adults, Medicaid is the difference between receiving compassionate care or being left to navigate an unsupportive system alone. If these proposed policies move forward, we risk isolating and endangering some of our most vulnerable community members.”
Work Requirements: A False Solution
One of the most alarming policy threats is the introduction of Medicaid work requirements—a policy that claims to encourage employment but, in reality, results in millions of people losing healthcare due to bureaucratic red tape.
In Georgia, work requirements cost $26 million, with 90% of funds spent on administration, not healthcare.
Kentucky estimated it would cost $270 million before courts blocked its implementation.
Nationally, 36 million people are at risk of losing Medicaid coverage—not because they are unemployed, but because of paperwork hurdles.
The reality is that most Medicaid enrollees who can work already do. Those who are not working are often disabled, caregivers, or students. Rather than creating jobs, work requirements strip coverage from those who need it most. Deb Migneault highlights:
“ A lifetime of economic disparities for older LGBTQ+ adults may mean that this population of individuals is disproportionally impacted by cuts to Medicaid, especially those using Medicaid to pay for their long-term care.”
The Rural Healthcare Crisis
In Connecticut’s rural communities, Medicaid is essential for keeping hospitals open. According to research from Georgetown University, rural residents are more likely to rely on Medicaid because they:
Earn lower wages and are less likely to have employer-sponsored insurance.
Work in small businesses that do not provide healthcare benefits.
Live in areas where hospitals depend on Medicaid reimbursements to stay afloat.
Every 1,000 Medicaid enrollees create 125 jobs, primarily in healthcare, construction, and retail. If funding is cut, rural hospitals will close, forcing residents to travel longer distances for emergency care and increasing preventable deaths.
What Connecticut Can Do
Medicaid is under attack, but these cuts and restrictions are not inevitable. Connecticut has an opportunity to:
Fight against block grants and work requirements that disproportionately harm disabled individuals, LGBTQ+ elders, and rural residents.
Advocate for Medicaid expansion to ensure that more people—especially those in underserved communities—can access care.
Push back against administrative barriers that force people to lose coverage due to paperwork issues, not genuine ineligibility.
The Time to Act is Now
Medicaid is more than just a government program—it’s a lifeline for Connecticut’s most vulnerable residents. The proposed restrictions would jeopardize care for LGBTQ+ older adults, increase healthcare disparities in rural areas, and force thousands of people to lose access to necessary services.
As policymakers debate the future of Medicaid, we must make our voices heard. Connecticut’s LGBTQ+ community, disability advocates, and healthcare professionals must stand together to protect the care that so many rely on.
Contact your representatives in Congress to advocate against Medicaid cuts. The future of Medicaid—and the lives of countless Connecticut residents—depends on it.
This article was contributed in conjunction with the UCONN Center on Aging.
