Care workers gather outside the Capitol in June 2025 to protest Medicaid cuts. Photo by Tasos Katopodis/Getty Images
By Hannah Feuer and Clara ShapiroJuly 3, 2025
At Jewish Home Family in northern New Jersey, seniors spend their golden years with access to kosher meals, weekly Shabbat services, and the spiritual support of on-site rabbis. Among the residents are Holocaust survivors receiving specialized care.
The 110-year-old nonprofit that began as an orphanage also prides itself on providing care to seniors irrespective of their financial means. So for Carol Silver Elliott, Jewish Home Family’s president and CEO, the passage of Trump’s “One Big Beautiful Bill” and potential cuts to Medicaid — roughly $1 trillion over a decade — are “very concerning.” Medicaid is the primary insurance provider for nearly two-thirds of U.S. nursing home residents, many of whom rely on the government program to cover long-term care.
“The people who are on Medicaid, the vast, vast majority of them, are people who’ve worked their whole lives, who’ve raised families, who contributed to our society, who donated to organizations,” she said. “These are people who have given a great deal, who we’re now turning our backs on as a country and saying, Oh, well, we’re not going to pay to help support your care. It’s worrisome.”
Prior to the latest legislative push, Medicaid was already underfunded, Elliott said, reimbursing $4 million less than the actual cost of care at Jewish Home Family each year. Additional cuts will exacerbate that shortfall, she said.
In New Jersey, where Jewish Home Family is located, state law requires 45% of nursing home residents and 10% of assisted living residents to be on Medicaid. Elliott said Jewish Home Family will continue caring for Medicaid-dependent seniors regardless of the bill, working to bridge financial gaps through increased philanthropic funding or cost-cutting measures.
But she’s worried about the impact on other facilities — particularly for-profit nursing homes in states that don’t mandate a minimum number of Medicaid patients. She fears those homes will increasingly turn away seniors who can’t afford to pay.
Some senior living facilities “will either find it impossible to continue to operate or will choose not to continue to operate,” Elliott said. “What happens to those people?”
Dr. Jeffrey Farber, president and CEO of The New Jewish Home, shares similar concerns. Of the roughly 4,000 seniors the organization cares for across New York City and Westchester County, 80% rely on Medicaid, he said.
According to Farber, Medicaid cuts will inevitably trickle down to both providers and patients — potentially leading to fewer available beds, greater difficulties hiring and retaining staff, and entire facility closures.
“Any cuts to Medicaid are going to have really devastating effects,” he said.
He quoted the late Rabbi Abraham Joshua Heschel, who once said, “A test of a people is how it behaves toward the old. It is easy to love children. Even tyrants and dictators make a point of being fond of children. But the affection and care for the old, the incurable, the helpless are the true gold mines of a culture.”
That ethos has guided the nonprofit since 1848, when Hannah Leo founded the organization through the B’nai Jeshurun Ladies’ Benevolent Society to support poor, aging Jewish women.
“We have to do better,” Farber said. “The Medicaid cuts — in whatever way, shape or form that they come from D.C. — it’s the exact opposite of what we need.”
The Senate passed the bill on Tuesday, with the tie-breaking vote cast by Vice President JD Vance, who posted to X that “the minutiae of the Medicaid policy” is “immaterial compared to the ICE money and immigration enforcement provisions” in the bill. The House passed the bill this afternoon. Trump is expected to sign it into law tomorrow.
Economically vulnerable Jews
Jews of all ages, not only seniors, could be affected by the bill. Around 20 to 25% of American Jews qualify as economically vulnerable according to “On the Edge: Voices of Economic Vulnerability in U.S. Jewish Communities,” a 2023 research study conducted by Tulane University researcher and sociologist Ilana Horwitz. The study’s findings not only dispel myths about Jewish poverty — how many Jewish people are affected by it, and what types of Jews — but allow for a more accurate assessment of how the anticipated Medicaid cuts will affect lower-income Jewish people.
The quarter of Jewish Americans who are economically vulnerable is not made up of a single demographic. “The general sort of stereotype in people’s minds is that Jews who are struggling are Holocaust survivors or Haredi,” Horwitz said. “Actually one group that really gets missed, that’s really often economically vulnerable, is Jews of no religion, Jews who are pretty disconnected — they actually have pretty high rates of struggle.” She added that single parents, educators, and people working in Jewish social service organizations are also disproportionately affected by poverty.
Jewish poverty is often a result of situational vulnerability rather than generational poverty, according to Horwitz. Situational vulnerability refers to an unexpected event, such as a divorce, the death of a family member, a disability, or an illness, that prevents you from paying the bills, and might send you spiraling into poverty. In the survey of 1,000 American Jews that Horwitz conducted as part of her study, she was surprised by how often she heard about situational vulnerability and downward mobility.
“I heard a lot of stories of people being like, ‘I grew up solidly middle-upper class, and then I got sick, or then I got divorced, or then my partner or my child got really sick, and I ended up becoming a primary caretaker,’” she said.
For Jews who are already adrift from their local Jewish communities, there is no spiritual or financial safety net to catch them. But even Jewish people who are involved in the community, Horwitz’s research found, are at risk of dropping out of their synagogues and other Jewish circles when faced with a disruption to the family structure.
“One of things that we realized is how much an interruption in the family structure interrupts also your Jewish participation,” Horwitz said. “Because if you think about it, so much of Jewish life, particularly in the synagogue, focuses around family events.” Embarrassed by presenting an ‘irregular’ family structure at shul, or simply unable to afford synagogue fees anymore, Jews already experiencing situational vulnerability may become alienated from the Jewish community at the time they need it most.
To Horwitz, these Medicaid cuts should challenge Jews to respond with a rallying cry of solidarity. “The positive thing I think could come out of this is that this is an opportunity for synagogues to really function as a safety net, because synagogues don’t rely on federal funding, right?” she said. “Jewish communities have survived persecution and poverty for millenia by taking care of each other, and these proposed cuts challenge us to live out our values. Each synagogue should be a beacon announcing, ‘If you are hungry, we will feed you. If you are sick, we will help you get care. If you are struggling, you are not alone.’ That is what it should mean to be part of the Jewish community.”
