By Vincent Tilford
Guest Opinion
As CEO of the Hannan Center, my daily question is simple but urgent: How do we ensure that metro Detroit’s older adults retain both their resources and their dignity? For the past 100 years, we’ve supported seniors in Oakland, Macomb and Wayne counties through good times and bad. But today, Federal cuts will roll back decades of progress and risk a return to a past none of us want to relive.
Our founder, Luella Hannan, launched this organization in 1925 well before Social Security, Medicare or Medicaid existed. Older adults often slipped through the cracks, especially during the Great Depression. Just as seniors in Detroit faced abandonment during those years, similar hardships rippled across communities from Pontiac to Mount Clemens. When demand surged while resources dwindled, Hannan was nearly pushed to bankruptcy because charity alone could not make up for systemic failure.
Fast forward to today, and we must not let history repeat itself. Expecting nonprofits and volunteers to fill the gaps left by policy dismantling is neither honorable nor sustainable. Bake sales cannot provide the safety net that our seniors deserve.
How the Big Beautiful Bill Act worsens care for seniors
The Big Beautiful Bill Act, pitched as cost control and anti-fraud legislation, includes provisions that would cut Medicaid, impose restrictive enrollment rules, new work requirements, and shrink provider networks. These changes would have devastating consequences for older adults and their caregivers. When retirement savings are gone, Medicaid is often the only thing keeping seniors in safe and supportive care, because Medicare does not cover long-term or custodial care. Restrictive re-enrollment requirements, such as demanding seniors reapply biannually, create unnecessary barriers for people who already face mobility or accessibility challenges. Narrowing provider networks leads to longer delays in accessing specialists.
The new administrative hurdles will inevitably push more people off coverage. A missed form or minor paperwork error could leave seniors uninsured. And when coverage disappears, the only place left to turn is the emergency room. Under federal law, hospitals must treat anyone who arrives, regardless of ability to pay. For many uninsured seniors, the ER becomes their healthcare system.
I once waited 24 hours to be admitted into the ER with insurance that was considered “good.” Imagine the impact when thousands more people show up uninsured. Hospitals across metro Detroit are already stretched thin. If this bill passes, delays will grow, outcomes will worsen, and our health systems will face collapse.
Medicaid is a lifeline for a quarter of Michigan residents. According to the Michigan Department of Health & Human Services, more than 2.6 million people, including about 168,000 seniors, rely on it every month for healthcare and support services. Cutting back this vital safety net does not just harm individuals, it sends shockwaves through families, neighborhoods, and hospitals across the state.
What we stand to lose
At Hannan, we see these stakes every day. One 80-year-old client depends on her daughter’s Medicaid coverage for dementia services. Another woman, Angela, left her job to care for her husband with Alzheimer’s. Medicaid supports her caregiving role and provides health insurance for their household. Without it, both families would free-fall into poverty. These are not rare cases. They represent the very people our systems are supposed to protect. Weakening Medicaid and Medicare does not only hurt “others.” It hurts us all.
A functional society does not force older adults to languish in waiting rooms or prove their “worthiness” for care. But that is what this new law risks doing. We have seen what happens when need collides with neglect. Before Medicare, Medicaid and Social Security, charities were overwhelmed, families crumbled, and seniors paid the price.
The Big Beautiful Bill Act jeopardizes not just programs but also our collective belief that healthcare is a right, not a privilege. It does not have to be this way. I urge families, legislators, and advocates across Michigan to stand up for seniors, protect Medicaid, preserve Medicare, and ensure that emergency rooms remain a backstop rather than the front door to healthcare. For Michigan’s older adults, and for all of us, the difference could be life itself.
Vincent Tilford, a Rochester Hills resident, is president and CEO of the Hannan Center, a Detroit-based nonprofit founded in 1925 that provides programs and services to support the independence and dignity of older adults in Macomb, Oakland and Wayne counties.
