Everyday Americans, not executives, will feel the pain of Medicaid cuts

President Trump’s proposed $880 billion in Medicaid cuts could leave 20 million people uninsured, destabilizing our entire health care system.

These aren’t just budget cuts — they’re an assault on your health coverage.

Get ready to wait — longer and longer — because when hospitals can’t afford to stay fully staffed, your care takes a back seat. The effect of budget cuts will hit hospitals in two devastating ways: Costs will soar as uninsured patients flood emergency rooms, and revenues will plummet as fewer Medicaid patients access non-emergency services. When hospitals lose money, everyone pays the price.

Medicaid is a lifeline woven deep into the fabric of American health care. Medicaid covers one in four Americans, including nearly 50 percent of children. Nearly 65 percent of those receiving long-term care services for chronic conditions — our parents, grandparents and vulnerable neighbors — are covered under Medicaid.

When millions suddenly cannot afford insurance anymore, they won’t disappear — they will show up in emergency rooms, because they have nowhere else to go. Preventive care will plummet, leading to more advanced illnesses and more costly treatments.

Hospitals, legally bound to treat all emergency room patients regardless of their ability to pay, will be forced to absorb enormous costs without full reimbursements. This will financially cripple health care providers, especially smaller hospitals, pushing them to the brink of closure.

The end result? Emergency rooms overflow. Staff get laid off. Those who remain burn out. Fewer doctors, fewer nurses, less care. Quality will nosedive. And it’s not just the uninsured who will suffer — these cuts will drag down health care for every single one of us.

Note that Medicaid covers nearly half of all U.S. births, offering vital prenatal, maternal and postnatal care to low-income women. It also funds the largest share of mental health care, supporting millions battling depression, trauma and addiction.

Slashing Medicaid means gutting essential care for mothers, babies and those in crisis. When emergency rooms become mental health wards, wait times for everyone — whether for a broken bone or a heart attack — will spike.

Budget cuts at this scale aren't just numbers on a page — they trigger real-world crises, overwhelming emergency rooms, shuttering hospitals, and compromising care for every single one of us.

Fewer Medicaid members mean fewer revenues from all non-ER touchpoints — surgeries, maternity care, long-term care and more. It’s not just emergency rooms feeling the pinch; entire service lines take a hit. And if you’re a community health care center, where nearly 45 percent of your revenue comes from Medicaid, you’re staring off a financial cliff.

We know exactly how this story unfolds because we just lived through it. During the COVID-19 pandemic, when elective surgeries were halted and emergency room visits rose by 45 percent, hospitals nationwide saw their income plummet and their costs rise. Emergency department boarding times doubled to seven hours.

The Mayo Clinic alone faced a staggering $900 million shortfall, forcing pay cuts and furloughs for over 20,000 employees. The damage wasn’t limited to big institutions, either — 18 rural hospitals shut down in 2020 alone. Patient experiences deteriorated, with significant declines in staff responsiveness and cleanliness.

The proposed Medicaid budget cut will have repercussions far longer and wider than that. Unlike the COVID-19 crisis, there's no vaccine to save the day. It might seem like hospitals can always absorb these costs, but let’s be real — when have we ever seen a struggling company serve its customers well? If an entire industry is forced to cut back, it won’t be executives who feel the squeeze — it will be you, the patient.

Granted, reducing the federal deficit is important. But slashing Medicaid to do it is like using an axe where we need a scalpel — brutal, imprecise and dangerously shortsighted.

Imagine needing urgent care but finding yourself stuck in a never-ending line because hospitals are underfunded, understaffed and overwhelmed. Already, patients in Boston face an average wait of 71 days to see a physician, with some specialties like gastroenterology experiencing delays up to 186 days. With these cuts, expect wait times to stretch even longer.

Reduced health care access isn’t just about numbers — it’s about lives. It’s about women losing prenatal and reproductive care. It’s about survivors of domestic violence losing trauma counseling. It’s about families watching critical support vanish.

When hospitals run on financial fumes, the most vulnerable suffer first — but eventually, we all do.

Mathangi Swaminathan is the founder and CEO of Parity Lab and a policy researcher recognized by Harvard’s Jane Mansbridge Award. Vamsee Prateek Gurram is the director of Strategy at Molina Healthcare.

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