Older adults — who have spent lifetimes building communities, fueling economies and shaping civic life — are navigating an increasingly fragile landscape. American systems that once promised stability and care in later life are being radically scaled down just as the need for support grows. The recently passed One Big Beautiful Bill Act (OBBBA) slashes over $1 trillion in federal Medicaid funding and will cut roughly $287 billion from food assistance programs over the next decade, threatening services on which millions of older adults depend. KFF analysis shows that a total of about 17 million people could become uninsured — representing the biggest rollback of health insurance coverage ever due to federal policy changes.
At the same time, philanthropic funders are retreating from their commitments to diversity, equity and inclusion. Amidst rising anti-DEI sentiments and policy shifts, a growing number of funders have quietly stepped back from equity-focused giving under political pressure. Major nonprofits and foundations are removing references to race, equity and identity from their strategies and messaging — as if the rich histories and invaluable contributions of the populations they serve are somehow no longer relevant to the conditions that philanthropy seeks to address.
This convergence creates a double abandonment that hits hardest in communities already facing systemic barriers to healthcare access. Most of the coverage losses from the OBBBA would come from cuts to Medicaid, which disproportionately impact older adults who rely on the program for long-term care services. For millions of older adults of color — who have earned these programs through lifetimes of work, taxes and community-building — these cuts mean losing access to basic care, transportation and support services that allow them to thrive. The reductions also represent a fundamental threat to the long-term care infrastructure that older adults depend on, particularly those with lower incomes who cannot afford private care options.
Now is the time for funders to double down — with sustained, equity-driven giving, support for advocacy, and investments that honor and strengthen support for elders and their families.
Why it matters
María, a 67-year-old, second-generation Mexican American elder, built a life of service — caring for others as a certified home health aide, while also serving as the anchor of her extended family. Today, she lives alone in a small apartment in San Francisco and relies on community-based services for transport to medical appointments and to stay connected to others. The local nonprofit that supports her recently lost a city contract as well as a major funder due to a “strategic shift.” The organization now operates with fewer staff, shorter hours and more uncertainty. María feels the difference — not just in the services, but in the silence.
María’s story reflects a broader truth. Older adults of color are more likely to experience economic insecurity, chronic illness and inadequate access to care. As reported by KFF News, these disparities are rooted in a lifetime of unequal opportunities and systemic barriers — and they deepen with age. Yet the organizations that serve these communities often remain underfunded and overlooked.
The impact is already reverberating across the country. Rural states such as North Carolina and Kentucky are expected to face particularly severe impacts, including widespread hospital closures, with consequences extending far beyond healthcare access to economic and social stability. In California alone, the state faces potential losses of billions in federal Medicaid funding, threatening services for over 15 million residents who rely on the program. For community-based nonprofits already struggling with reduced philanthropic support, the loss of Medicaid funding creates a perfect storm of service reduction precisely when underserved older adults need support most.
The burgeoning reality is that María and millions more like her are now coming face to face with a double threat: philanthropic funders retreating from equity-focused giving just as federal safety net programs receive unprecedented cuts. The organizations that have historically served as bridges between policy gaps and community needs find themselves caught between shrinking private dollars and disappearing public resources.
Now is not the time to pause or dilute DEI investments. It’s time to sharpen focus and recognize that the passage of the OBBBA makes equity-centered philanthropy more critical than ever. When the government abandons its responsibility to the most marginalized, funders must step up — not step back.
What funders can do now
- Fund with an equity lens — without apology. This includes long-term, unrestricted support for organizations led by and serving older adults of color. Don’t dilute the mission. Deepen it.
- Strengthen advocacy infrastructure. Fund organizing, policy advocacy and leadership development among older adults and caregivers. Support groups like Justice in Aging, the Diverse Elders Coalition and Caring Across Generations, who are mobilizing to protect rights, access and dignity for all elders.
- Invest in narrative change. Research from the FrameWorks Institute shows that how we talk about aging shapes public understanding and policy decisions. Fund efforts that challenge ageist assumptions and uplift older adults — especially those who are Black, Indigenous, immigrant, LGBTQ+ or disabled — as culture-keepers, community anchors and leaders.
- Increase annual giving in response to compounding need. With philanthropic giving declining overall and critical federal programs like Medicaid experiencing budget cuts, philanthropy must respond with urgency. Now is the time to increase — not shrink — support for community-based organizations serving older adults who are bearing the brunt of these intersecting crises.
- Stay accountable. If your institution is shifting DEI strategies, be transparent about how you’re continuing to serve communities most impacted by systemic inequity — including older adults.
A long-term investment in justice
Philanthropy holds a unique power to sustain a long view on the work — even when the political climate turns, and especially when it feels like hope and practical options are running low. Supporting older adults — particularly those who have been historically excluded — is not a trend. It’s a core responsibility.
The elders who led movements, nurtured generations and shaped communities with unwavering strength deserve more than gratitude. They deserve policies, funding and visibility that reflect the power of their lives — and the future they’ve made possible for all of us. While this moment is deeply troubling and sobering for so many of us, we must not lose courage. As Dr. Martin Luther King Jr. reminded us, “We must accept finite disappointment, but never lose infinite hope.”
At this precarious moment, we urge funders to recommit to the noble pursuit of equity — starting with those who are too often invisible in both policy and philanthropy: older adults of color.
Janet Y. Spears is President and CEO of Metta Fund, a $75 million San Francisco foundation advancing aging population health through trust-based, equity-centered grantmaking and multigenerational community building.
Anna Karrer Manley leads institutional communications, external engagement and narrative change initiatives at Metta Fund, serving as a strategic advisor to the CEO while collaborating with program staff to amplify the foundation’s impact and reach.
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