Administration for Community Living Cut

The Trump administration’s decision to eliminate the Administration for Community Living (ACL) and fold its responsibilities into other HHS agencies is a quiet but deeply damaging move. This is not merely a bureaucratic reshuffle, but rather an abandonment of the federal government’s only dedicated advocate for older adults and adults with disabilities.

ACL existed to support services that help seniors remain independent and out of institutional care; such as Meals on Wheels, caregiver support, transportation assistance, and more. Though these programs may survive on paper under CMS or ACF, the loss of centralized leadership and dedicated advocacy puts millions of vulnerable adults—especially those not under Medicaid—at serious risk.

Handing aging support programs to the Centers for Medicare and Medicaid Services (CMS), whose mission is to administer massive health insurance programs, guarantees neglect. CMS isn’t equipped to deliver or prioritize these types of non-medical services. These tasks are not reimbursable, do not fit their workflow, and simply won’t be prioritized. Similarly, giving adult disability programs to the Administration for Children and Families (ACF), which focuses on child welfare and family assistance, makes equally little sense. Adult disability issues will be foreign to their mission and will not be prioritized.

This decision strips aging and disability populations of their only institutional advocate at the federal level. It ensures that middle-income and low-income seniors will face greater barriers to the social supports they need to stay out of nursing homes. And when those supports disappear, many of these individuals—particularly those not yet financially challenged enough to qualify for Medicaid—find themselves with no real options left. Aging in place becomes logistically impossible, and families are pushed toward institutionalization not because it’s the best option, but because it’s the only one still available.

This slow erosion of support effectively funnels more people into the long-term care system, where they’re far more likely to become Medicaid-eligible after spending down assets. And for many nursing homes, that’s the goal: to fill beds and keep a steady stream of reimbursable residents, regardless of whether those residents ever wanted to be there in the first place. It exacerbates systemic problems we already see every day in the nursing home industry.

At 82 years old, Susan is losing more than a ride to the doctor or a warm meal—she’s losing her dignity, her independence, and her last chance to age on her own terms.