Resistance Grows as Proposed Cuts Threaten Health Care for Over 79 Million in US


Planned cuts to Medicaid and CHIP will put more than 79 million people at medical risk. But resistance is mounting.

By Eleanor J. Bader , 

Truthout

Published

April 6, 2025

Medicaid recipient Emily Gabriella protests outside the Supreme Court as oral arguments are delivered in the case of Medina v. Planned Parenthood South Atlantic on April 2, 2025, in Washington D.C.Kayla Bartkowski/Getty Images

Kelly Smith, a 57-year-old New York City resident, is part of the Nonviolent Medicaid Army (NVMA), a growing national movement of poor people who are organizing to stop proposed cuts to Medicaid and promote health care as a human right.

“The need for health care unites us all,” Smith told Truthout. “Right now, I’m terrified of losing Medicaid and being unable to get injections for pain control. They’re the only thing that makes it possible for me to be on my game.”

Nonetheless, she says that her health is somewhat fragile. Not only is she a breast cancer survivor, but she also has severe scoliosis and takes medication for hypertension, high cholesterol and depression — all covered by Medicaid.

That this coverage might end or be reduced — a real possibility if Congress approves pending budget cuts to satisfy DOGE and the Trump administration — terrifies her and other members of the NVMA. Their work is twofold: They are mobilizing against recently announced threats to curtail Medicaid while also organizing to ensure that health care is recognized as a human right.

“We’re organizing call-in days to tell lawmakers our stories and let them know the value of Medicaid in our lives. We’re also attending town halls,” Smith said.

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“We have to eliminate the shame associated with disability and poverty.”

According to the Center on Budget and Policy Priorities, Medicaid currently covers 72.1 million people. The program was first established in 1965 as part of the “war on poverty,” and was initially meant to provide health care to recipients of Aid to Families with Dependent Children, a welfare program. In the 60 years since, it has expanded to cover low-income children and adults as well as those living in nursing homes or in need of home care.

Its reach is significant: KFF reports that in 2023, 41 percent of births were financed by Medicaid. Moreover, 1 in 6 adults aged 19-64, 2 in 3 nursing home residents and 1 in 3 adults with disabilities got their health care through a Medicaid program.

Children also benefit. The Children’s Health Insurance Program (CHIP) extended health coverage to families deemed over-income for Medicaid but still too poor to buy private health insurance. As of October 2024, more than 7 million children were enrolled.

All told, Medicaid and CHIP serve more than 79 million U.S. residents. And while these programs vary by state, as a joint federal-state partnership, the programs ensure that low-income children and adults have at least minimal access to care.

But it doesn’t come cheap. KFF reports that between October 1, 2023, and September 30, 2024, the government spent more than $860 billion, not including administrative costs, on Medicaid programs. Not surprisingly, this has put them squarely in the crosshairs of Elon Musk’s so-called “Department of Government Efficiency” (DOGE), which has pledged to slash the social safety net. As has been widely reported, the resultant “savings” will be used to finance tax cuts of $1.1 trillion, money that will benefit only the wealthiest 1 percent of the country — giving an average annual tax break of $62,000 to those with incomes of $743,000 or more through 2034.


“We all deserve health care. As poor and working-class people, we’re sick of being treated as if we don’t matter.”

Kelly Smith and the Nonviolent Medicaid Army call this abhorrent. And they’re far from alone in arguing that cuts to Medicaid and CHIP will worsen public health and cause enormous hardships for millions of U.S. residents.

Kym Clarine, a certified nursing assistant from the Bronx, told Truthout that if she loses Medicaid, she will have to forgo her annual physical exam, and neither she nor her 12-year-old daughter will be able to visit the dentist for regular check-ups. “Each visit costs $150 without insurance,” she said. “I can’t afford that.”

Sheila Bingham of Little Rock, Arkansas, will also be negatively impacted if the cuts come to fruition. The 47-year-old receives both Medicare and Medicaid and is being treated for a rare cancer, debilitating migraines, type 2 diabetes, erratic blood pressure and intense pain. “I rely on Medicaid to pay my Medicare premium of $106 a month,” she told Truthout. “I won’t survive if they start taking this out of my $1,400 disability check.”

Alex Fisher is in similar straits. A self-employed 63-year-old, Fisher has been on Medicaid since 2011. “Medicaid has covered three wrist surgeries, a breast reduction, and my dental and optical care,” they told Truthout. “I’ve been going to rallies and writing and visiting my legislators to express my outrage, but I’m scared that I might lose coverage. As I get older, I know that I’ll need more care, not less, and even when I become eligible for Medicare at age 65, I know that it won’t cover many of the services I need.”

Yet despite this escalating anxiety, Vania Leveille, senior legislative counsel at the ACLU, told Truthout that no one knows exactly how the budget cuts will unfold. “First, the House and the Senate had to pass their own budget resolutions,” she explains. “Both bodies are now moving to negotiate and reconcile the two bills. They will then lay out the specifics of the cuts they intend to make.”

But even before this is fully spelled out, opposition to Medicaid cuts is mounting. Already, groups including the National Conference of Mayors, the National League of Cities, The Council of State Governments, the National Association of Counties and the National Conference of State Legislators have told federal lawmakers that they oppose rollbacks of medical coverage. Similarly, the National Medicaid in Schools Coalition, a group of 65 organizations, has written a letter to Congress stressing that “children cannot learn to their fullest potential with unmet health needs.” The coalition adds that services to special education students — including occupational, physical and speech therapy; mental health counseling; and adaptive equipment — are often paid for by Medicaid. “A 2023 Congressional Budget Office analysis found that just one extra year of Medicaid coverage during childhood leads to higher earnings and better productivity as an adult, boosting the nation’s economy,” the letter notes.

Georges Benjamin, executive director of the American Public Health Association, told Truthout that in addition to stressing the value of Medicaid in keeping people healthy, the public needs to be reminded that Medicaid is an insurance program for people who need it. “Politicians who brand it as a program for low-income people who are unwilling to work are incorrect. The American people need to be armed with facts. Medicaid cuts will make more people sick, will make more people die and will close more rural hospitals,” he said.

Benjamin also predicts other impacts, including an increase in health insurance premiums for non-Medicaid recipients. “Hospitals will need to recoup the money they’ve lost so they will charge insurers more,” he said. He further denounces a proposal to impose “a per capita cap on care” — a maximum that can be paid for each person’s medical care — saying that it will lead to less health care.

Work requirements for Medicaid recipients, another idea being floated by the GOP, are also flawed, Benjamin adds. “The real goal of work requirements is to kick people off the rolls. These are people who are already struggling, those with the least money and the least internet access, making it hard for them to complete the required paperwork.” In addition, approximately two-thirds of Medicaid recipients are already working, he adds, with those who are not likely exempt because of age or infirmity.

Then there’s the idea that the state-federal funding balance should shift to make states pay a higher percentage of Medicaid costs. “Poor states, many of them red, receive a bigger match from the feds,” Benjamin said. “If the feds reduce the amount they give to the states, many will have to either raise taxes or reduce services.”

What’s more, he says that many health centers, particularly those in remote, rural areas, operate on a shoestring budget. “Many are two or three weeks away from not making payroll,” Benjamin reports. The likely result? The closure of clinics, hospitals and health centers in already underserved areas.

Elizabeth Zhang, research assistant for health policy at the Center on Budget and Policy Priorities, told Truthout that cuts to Medicaid are also likely to increase medical debt. The federal government mandates the type of care that Medicaid must provide (including transportation to medical care; inpatient and outpatient hospital services; lab tests and X-rays; nursing facility services and family planning), and which are optional (such as private-duty nursing; dental care; physical, occupational and speech therapy; dentures; prosthetics; eyeglasses and hospice). “If cuts go through, states will have to make difficult decisions about what they’ll do,” Zhang said. “There is already quite a lot of variation, with some states being pretty bare bones and others covering more services. Poorer states are lean, so if they cut services, it’s likely that more people will go into debt to pay for care.”

Sandy Santana, executive director of Children’s Rights, a 30-year-old group that works to protect abused and neglected children, says that an additional possible consequence of the proposed cuts — and cuts to the social safety net more generally — is that more people living in financial precarity may be judged as unfit parents. “A lot of why kids end up in foster care in the first place is a judgment of neglect,” he said. “This often conflates with poverty, and our biggest worry is that cuts to the social safety net will drive more kids into the child welfare system.” Moreover, he says, when there are insufficient kinship or home placements, children may be placed in congregate care settings that he calls “unhealthy for child development.” He also fears that legislation allowing children to stay on Medicaid until age 26 will be rescinded — something that will adversely impact those who age out of foster care at 21.

“There is such short-sightedness in all of this,” Santana told Truthout. “Studies show that Medicaid leads to reduced child welfare involvement. When children get early health care, they have better health outcomes that last into adulthood. This is not a niche program. Almost half of the U.S. population relies on Medicaid.”

This is especially evident in immigrant communities.

Paula A. Arboleda, director of health advocacy at Bronx Legal Services, told Truthout that the intersection of immigration crackdowns and budget cutbacks is making many noncitizens afraid to enroll their U.S. citizen children in Medicaid or CHIP, or to renew their eligibility. “During the pandemic, no one had to renew their coverage, but that policy has ended, and every Medicaid recipient now has to complete a nine-page renewal form. There is an online portal, or people can mail the form in, but we’re seeing a lot of noncitizens who are afraid to do this. They’ve heard that there are rules prohibiting them from becoming a public charge, but this only applies to benefits a noncitizen receives for themselves, not as a payee for a U.S. citizen child,” she says.

Nonetheless, Arboleda says that she understands the fear that she is seeing and hearing. Part of this rests with uncertainty since no one knows how the budget negotiations will play out.

Brooklyn, New York, parent Rachelle Kivanoski is the mother of a 42-year-old son who has an intellectual disability. He has been living in a four-person group home since 2020, and although he currently has both Medicare and Medicaid, Kivanoski told Truthout that she worries that changes might close some programs or diminish the services that he receives. “The expectation is that something truly catastrophic will happen,” she said. “So many services are provided by Medicaid here in New York — community day programs, group homes, employment projects. Everyone who can is going to demonstrations, signing petitions, and calling and visiting lawmakers at every level of government, but especially in Congress.”

Smith of the Nonviolent Medicaid Army says that this is imperative. “The time is now,” she said. “Unfortunately, Medicaid usually does not get talked about unless it’s under attack. We aim to change that and create long-term solutions by developing leaders among those who are directly impacted by the policies being considered. We all deserve health care. As poor and working-class people, we’re sick of being treated as if we don’t matter.”

This article is licensed under Creative Commons (CC BY-NC-ND 4.0), and you are free to share and republish under the terms of the license.

Eleanor J. Bader is a Brooklyn, New York-based freelance writer who focuses on domestic social issues and resistance movements. In addition to Truthout, she writes for The Progressive, Ms. Magazine, Lilith, The Indypendent, New Pages and other progressive blogs and print publications.