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-Editorial
In what would be the most significant reduction in the history of Medicaid, the U.S. House of Representatives last month passed a budget resolution slashing $800 billion from the federal healthcare program. The Senate is now set to debate a similar measure in April, raising alarms among health policy experts and advocates who warn that these cuts could leave millions of Americans—especially low-income families and communities of color—without access to healthcare.
The impact of the proposed reductions would be particularly devastating for Latino and Black families. More than 20 million Latinos, 13 million Black individuals, and 3.5 million Asian Americans currently rely on Medicaid for healthcare coverage. Additionally, 31 million children, covered through the Children’s Health Insurance Program (CHIP), could face disruptions in their access to care. In California, Medicaid operates as Medi-Cal, covering nearly one-third of the state’s population.
Healthcare policy leaders and civil rights organizations have sounded the alarm about the consequences of these cuts. At a recent press briefing, Stan Dorn, Director of the Health Policy Project at UnidosUS, emphasized the unprecedented scale of the reductions.
“The magnitude of these cuts is just extraordinary—nothing in American history has been remotely this size,” Dorn said. “We estimate that these Medicaid cuts are larger than any that have ever been made, by a considerable margin.”
The House budget resolution passed on a strict party-line vote, with nearly all Republicans in favor and all Democrats opposed. According to Dorn, the proposed cuts aim to offset the cost of extending the 2017 Trump tax cuts, which primarily benefited large corporations and wealthy individuals.
“These cuts would take healthcare away from working people, middle-class families, and communities of color, all to fund tax breaks for the wealthy,” Dorn said.
An analysis by multiple civil rights and health equity organizations has highlighted the disproportionate effect the cuts would have on communities of color.
“More than 20 million Latinos rely on Medicaid—that’s nearly a third of the entire Latino community,” Dorn noted. “Among African Americans, more than 13 million are covered by Medicaid, including nearly 60% of all Black children.”
He also stressed that Medicaid plays a crucial role in providing long-term care for older adults, particularly in Black and Native American communities, where many individuals depend on the program for nursing home services and in-home care.
The Medicaid cuts are set to advance through the budget reconciliation process, a legislative maneuver that allows the Senate to pass spending bills with a simple majority, avoiding the usual 60-vote threshold required to overcome a filibuster.
Among the key proposals being considered in the House budget are strict work requirements for Medicaid recipients, which health policy experts warn could lead to fewer people working. The budget also includes state funding limitations that could severely restrict how states fund their Medicaid programs, forcing them to make drastic cuts to essential services or reduce spending in areas like education and public safety. Furthermore, proposed federal spending caps on Medicaid per person could result in states cutting coverage for millions of Americans, further exacerbating the healthcare crisis.
“These proposals shift the financial burden onto the states, but most states are already struggling with budget shortfalls,” Dorn said. “The reality is, millions of people will lose coverage.”
Beyond the immediate healthcare impact, experts warn that these cuts could destabilize local economies.
“Medicaid is not just a safety net—it’s an economic driver,” said John Priest, Director of Government and External Affairs for the Community Clinic Association of Los Angeles County. “Hospitals, community clinics, and healthcare providers rely on these funds to keep their doors open. If these cuts go through, we will see more clinic closures, fewer doctors accepting Medicaid patients, and increased pressure on emergency rooms.”
Anthony Wright, Executive Director of Families USA, pointed out the political risk of such cuts.
“The bottom line is, people voted last November to lower costs,” Wright said. “Instead, these cuts will leave families with higher medical bills, less access to care, and more financial insecurity.”
Joan Alker, Executive Director of the Center for Children and Families at Georgetown University, emphasized Medicaid’s essential role in covering children and the elderly.
“Medicaid covers nearly half of all children in the United States and 41% of all births,” Alker stated. “It is also the largest payer for behavioral health and mental health services, and it funds the majority of long-term care for seniors.”
She noted that Medicaid is particularly crucial for lower-income seniors, who often rely on it to supplement Medicare.
“Five out of eight seniors in nursing homes are covered by Medicaid, not Medicare,” she said.
State budgets would also be heavily impacted, as Medicaid is the largest source of federal funding for states
“Even states that wanted to raise taxes wouldn’t be able to compensate for the loss,” Alker said. “Many states are actually looking to cut taxes, not increase them.”
Rural areas would be among the hardest hit, as many hospitals and clinics in those regions depend on Medicaid reimbursements to stay open.
“Rural hospitals are closing at fast rates,” Alker said. “Many communities have already lost their labor and delivery units, forcing women to travel long distances to give birth. Cutting Medicaid will only worsen this crisis.”
Joanne Preece, Director of Government and External Affairs for the Community Clinic Association of Los Angeles County, warned that community health centers, which serve millions of low-income and uninsured patients, could see significant funding cuts.
“In many places, health centers are their patients’ only source for accessing high-quality care,” Preece said.
In Los Angeles County alone, 78% of health center patients rely on publicly funded healthcare through Medicaid or Medicare. The expansion of Medicaid under the Affordable Care Act dramatically reduced the uninsured rate, allowing health centers to offer more services and improve patient health outcomes.
“If these cuts happen, health centers may have to reduce operating hours, close in the evenings and on weekends, or cut vital services,” Preece said. “This will be devastating to the patients and to the organizations serving them.”
With the Senate preparing to debate the budget resolution in April, advocacy groups are mobilizing efforts to push back against the cuts.
“This is not what America voted for,” Dorn said. “We’ll see how it plays out, but the stakes could not be higher.”
Healthcare advocates are urging the public to contact their representatives, emphasizing that Medicaid is not just a program for the poor—it’s a lifeline for working families, children, seniors, and people with disabilities.
