Do Not Cast Them Off
A Meditation by Rev. Cameron Trimble
“Do not cast me off in the time of old age; do not forsake me when my strength is spent.” —Psalm 71:9
Last week, the US Administration announced a change that could impact how much millions of older Americans pay for their prescription drugs. The program’s name, Medicare Part D Premium Stabilization Demonstration, is enough to make anyone’s eyes glaze over.
The initiative began in 2025 with the aim of preventing abrupt increases in premiums when changes to Medicare prescription drug benefits were introduced. It achieved this by providing federal subsidies to reduce the premiums and by setting limits on the amount by which the plans could raise their rates. Nearly all of the eligible insurance plans took part. The Trump administration has decided to stop the program this year.1
It remains unclear what will happen next. Those enrolled in stand-alone Medicare Part D plans, amounting to about 25 million people, will find out their 2027 premiums this fall. Federal officials have stated that the majority of people will experience an increase of less than ten dollars per month, and in some cases they may even end up paying less. The annual cap on out-of-pocket prescription costs will remain in effect. This decision does not abolish the cap.
The administration also states that terminating the program will mean that billions of dollars paid by taxpayers will not go to private insurance companies. That is a sensible concern since the cost of the program in its first two years was expected to be $9.8 billion, most of which was intended to keep premiums low.
But the initial results were important. The Government Accountability Office discovered that the average monthly premiums had hardly changed during the first year of the program. If this additional assistance had not been provided, millions could have experienced large increases unless they had changed their plans. However, changing plans might involve finding out that a medicine now costs more or is no longer covered.
The Centers for Medicare & Medicaid Services has described the conclusion of this support phase as a return to “normal market conditions”.
It seems neutral, almost as though it were just the way things are, as if the market were returning to normal like the weather. But the market isn’t abstract when its effects are seen at someone’s kitchen table.
In some place an older woman is sitting at her table with a calculator, a list of prescriptions, and a fixed monthly income; she totals up the rent, the utilities, the groceries, the insurance, and the medicine which keeps her heart steady. The figures don’t add up.
Somewhere, a man cuts his pills in half to make them last. Someone else waits to refill a prescription until their Social Security check comes. An adult daughter compassionately pays her father’s copay, wondering how she’ll cover her own bills.
Ten dollars would appear to be a small amount at a policy meeting, but at that kitchen table it’s milk, it’s the cost of a bus ticket, it’s included in the electricity bill, and it’s the little birthday present that somebody had intended to buy for a grandchild.
The writer of Psalm 71 prays from the vulnerable edge of aging: “Do not cast me off in the time of old age; do not forsake me when my strength is spent.”
The psalm belongs to the sacred heritage of both Judaism and Christianity, but the fear it conveys extends beyond the scope of any single religion; it is the fear that as our bodies grow weaker, and we become less economically valuable, the community which previously depended on us will conclude that we are too costly to look after.
“Do not cast me off.” The prayer is meant for God, but I hear it as a call to all of us now.
Don’t abandon me when I am unable to work as I once did. Don’t abandon me when I need assistance with remembering the instructions. Don’t abandon me when my body requires expensive medicine, more doctor visits, or more time than a busy system is willing to provide. Do not reduce my life to a cost.
The way in which we look after older people reveals what we consider a human life to be worth; if dignity depends on productivity then aging means a gradual loss of value, but if dignity is held simply because we are alive then being in need of help does not take it away.
None of us stays independent forever. We start life needing to be fed, carried, and protected. Many of us will need those things again at the end of life. In between, we often pretend that being self-sufficient is normal. It isn’t.
We live because others care for us. We survive because generations have built systems to protect us: hospitals, public health programs, Social Security, Medicare, disability support, community clinics, family networks, and neighbors who notice when the lights stay off.
Before we accept that a policy change will have only a small effect, we should ask: Small for whom? Before we celebrate a return to normal market conditions, we should ask who will have to pay the price. Before we reduce care to just a budget line, we should remember the person praying, “Do not cast me off.”
Consider an older person that you know today. Find out what has become more difficult to afford and whether they are concerned about the cost of their prescriptions or the options for insurance. While listening, don’t feel the need to explain the policy or offer them reassurance immediately.
Consider what caring means to you; it might involve helping someone to compare plans, paying someone’s bill, contacting your representative, or simply making sure that someone knows they aren’t alone.
Growing old shouldn’t mean slowly fading from our care and concern. No one should have to wonder if the community that once relied on their work now thinks they’re too expensive to help. Do not cast them off.
We are in this together,
Cameron
Reflection Questions
What feelings arise in you when you imagine growing older and becoming more dependent upon others?
Who in your life may be frightened by the rising cost of medicine, food, housing, or care?
Where have complicated policy terms allowed you to look away from their human consequences?
What would it mean for your community to treat care for older people as a sacred responsibility?
A Prayer for the Day
A Prayer For Holding Us Through Every Age
God of our first breathand our final season, hold us through every age. When our hands are strong, teach us to use them for the care of others. When our steps become uncertain, send someone willing to walk beside us. When memory dims, remember us. When the cost of care is weighed against the value of a life, trouble every calculation that forgets the sacred. Be near those counting pills at kitchen tables tonight. Be near those choosing between medicine and food. Be near the children carrying their parents’ fear alongside their own. Make us a people who do not discard, a community that does not disappear when care becomes difficult. May no one grow old outside the circle of our concern. Amen.
Spiritual Practice
See the Person Behind the Policy
Choose one older person in your family, congregation, neighborhood, or community. Call or visit them this week.
Ask: “Is there anything about the cost of your medicine, insurance, food, or housing that is worrying you?”
Listen without interrupting or minimizing their concern. Ask whether practical help would be welcome.
Then take one action. Help compare Medicare plans, arrange transportation, contribute toward a cost, contact an elected representative, or connect the person with a trustworthy local resource.
Let your care become more than concern. Make sure someone knows they have not been cast off.
Upcoming Events That Might Be of Interest…
My team and I launched a new experiment we are calling “The Commons.” It’s an online space centered around communities of practice: groups of people who share a common concern, set of problems, or passion for a topic, and deepen their knowledge and expertise by interacting on an ongoing basis. Join the community here.
August 4 - September 1, 2026, 12:30-1:30pmET - Book Club in The Commons - FREE - We are reading our next book, “I Eat The Stars” by Sarah Wilson. We will meet each Tuesday for 6 weeks. It’s such great fun. I hope you will be a part. All are welcome! RSVP HERE.
August 6, 2026, 7-8pm ET - FREE EVENT - Join me in conversation with Rev. Natalia Terfa about her new book, “It All Counts: Finding God Beyond the Boundaries.” What if the moments you’ve been taught don’t “count” spiritually are actually where God is waiting to be found? Many of us were handed a version of faith that divided life into sacred and secular, holy and ordinary, faithful and doubtful. But what if those boundaries were never real? Whether you’ve left church, stayed in it, or find yourself somewhere in between, this conversation will offer fresh language for a faith that is expansive, embodied, and deeply human. REGISTER HERE.
August 20, 2026, 7-8:45pm ET - I will be joining Jackie Sussman for an online session on practicing eidetics as a part of our “Reclaiming the Power of Imagination” monthly series. Eidetic Imagery is a powerful tool for pastors, denominational leaders, coaches, and spiritual directors working with others, and for individuals seeking deeper integration and healing in their own lives. Jackie is a psychotherapist, author, and leading expert in Eidetic Image Psychology, and has spent over forty years helping leaders and individuals unlock creativity, uncover hidden strengths, and move through limiting patterns. During this session, she will lead a live Eidetic process shaped by mythic imagery, offering a direct experience of the work. REGISTER HERE.
September 8, 2026, 7-9pm ET, ONLINE EVENT - I’ll be hosting a powerful online gathering on The Black Madonna: Sacred Wisdom for a World in Crisis with Matthew Fox, Alessandra Belloni, and Christena Cleveland. We will explore the Black Madonna as a symbol of resilience, liberation, sacred feminine wisdom, and healing in a fractured world through conversation, story, music, and spiritual reflection. If you feel drawn toward a deeper encounter with the Divine Feminine and the ancient traditions that continue to nourish movements for justice and wholeness, I hope you’ll join us. Learn more and REGISTER HERE.
October 6, 2026 - 7-8:30pm ET, ONLINE EVENT - Matthew Fox and I are teaming up again to launch a series called Journeying with the Mystics. The mystics have always emerged in times of uncertainty. They appear when old certainties are crumbling, when institutions no longer provide easy answers, and when people find themselves longing for a deeper experience of the Sacred. Join us for an 18-session exploration of the teachings of St. John of the Cross, Thomas Merton, Hildegard of Bingen, Kabir and Rumi, Meister Eckhart and more. This is more than a lecture series. It is an invitation into a living spiritual journey. REGISTRATION COMING SOON!
October 18-21, 2026 - PREACH! 2026 Conference- I’ll be co-hosting PREACH in Minneapolis with Church Anew, a new gathering for preachers, storytellers, worship leaders, and spiritual communicators navigating what it means to speak with clarity, compassion, and courage in a changing world. If you’ve sensed that the preaching moment has changed and are longing for thoughtful community and renewed imagination for this work, I hope you’ll join us.
Fun Things My Friends Are Up To…
I get to work with such amazing, creative people. This section is my way of celebrating them—no paid promotions, just joy in what they’re creating.
Dr. Timothy Snyder, the author of On Tyranny, has publicly released the first lecture of a ten-lecture course he taught at the University of Toronto this past year. The course is called “Hitler and Stalin Today.” He is offering this as a public resource for students, researchers, and anyone interested in understanding the relationship between history and contemporary democracy. Follow his posts here or watch on YouTube.
July 29, 2026, 12pm ET - ONLINE WRITING GROUP - My dear friend, Meryl Marshall-Daniels, is leading a writing group open to all. This is a simple and spacious writing circle for people who want time to listen inwardly and put words on the page without overthinking, performing, or polishing. Meryl offers a prompt designed to invite reflection, imagination, and attunement to what is already alive within you. The practice honors writing as a way of listening, of letting images, memories, questions, and insights surface in their own time. Learn more here.
My friends over at Spiritual Wanderlust have some of the coolest classes. One I am particularly drawn to is their Celtic Spirituality School where you get to learn from people like John Philip Newell, Ilia Delio, Carl McColman, Sharon Blackie, and more. Read more about their program.
If you are a leader or member of a congregation looking for consulting support in visioning, planning, hiring or staffing, please consider Convergence.
Thank you for making Psalm 71 today's reality test.