Medicaid saves people in Missouri and Kansas. Trump and the GOP want to gut it | Opinion

Medicaid and CHIP, the Children’s Health Insurance Program, are a backbone of American health care, covering more than 79 million people across race, income and geography. That includes more than 1.2 million Missourians, and 411,000-plus residents of Kansas, where lawmakers continue to refuse to expand the program.

Medicaid funds health care for nearly half of all births, two-thirds of nursing home residents and millions of people with disabilities. Yet, despite broad bipartisan support and positive views of the program among voters, President Donald Trump and congressional Republicans are pushing deep cuts to Medicaid to pay for $2 trillion to $2.5 trillion in tax breaks for billionaires and corporations. They might claim otherwise, but the House budget Trump endorsed requires the House Energy and Commerce Committee, which funds Medicaid, to slash $880 billion from its programs. The Congressional Budget Office has confirmed that cutting Medicaid and CHIP is the only way to achieve those goals.

The real impact of these cuts would be on families who rely on Medicaid for essential, lifesaving care. Trump’s claims that his cuts would strengthen the economy are bogus. Sick people would call out of work, and hospitals that are often the largest employers of whole communities would shut down — and none of that bodes well for the local or national economy. Trump’s plan would drive up medical debt, force more people into emergency rooms and leave families with impossible choices between life and debt.

These cuts would hit hardest where health care access is already fragile — rural communities, families with low incomes, Black people, Latino Americans, kids and people with disabilities. Millions of women and children rely on Medicaid for essential care, particularly in states where Medicaid expansion has helped keep rural hospitals open and reduced infant mortality. Across the country, people continue to organize to defend their health, refusing to let politicians dismantle a program that keeps communities stable.

In 2017, groups such as Community Catalyst, Community Change and our grassroots partners organized tens of thousands of people nationwide to protect the Affordable Care Act, Medicaid and SNAP. When the Beltway conventional wisdom was that we would lose this fight, we showed up in Congress, made phone calls to legislators, lifted up the voices of directly impacted people and more. With smart strategy and organized people, we won. The coalition was able to block Trump’s first attempt at gutting the safety net — and now we’re geared up to fight again.

Children, older adults, people with disabilities

Coming up on its 60th anniversary this year, Medicaid is one of the most efficient and cost-effective insurance programs in U.S. history, with lower administrative costs than private insurance. The majority of recipients are children, students, older adults and people with disabilities — those who will lose care first if funding is slashed. In some states, Medicaid covers more than half of all children — a lifeline for families who would otherwise be uninsured. Cuts would also impact health services provided to young students.

Beyond health coverage, roughly 4.5 million people rely on Medicaid-funded Home and Community-Based Services as an alternative to institutionalization. These waivers help pay for home health care workers, durable medical equipment, career coaching, case management and other essential services, allowing people to live independently and stay connected to their communities — and creating thousands of jobs for care workers. In fact, studies show that the expansion of HCBS leads to less nursing home spending and more individuals receiving care.

Yet instead of strengthening this critical program, some lawmakers are pushing work requirements — a policy that has repeatedly failed and wasted taxpayer dollars. When Arkansas implemented a similar policy under the Trump administration, more than 18,000 people lost coverage — not because they weren’t working, but because of excess administrative red tape and paperwork barriers.

Now, Georgia is repeating the mistake, and taxpayers are footing the bill for unnecessary bureaucratic hurdles that only benefit private contractors. Despite millions in administrative spending, only about 6,500 people have enrolled out of an estimated 175,000 eligible individuals. The bulk of the funding has gone to third-party vendors and administrative costs — not actual health care for the people who need it most. Everyone should have access to guaranteed, high-quality care, but these Republican-backed policies force people out of coverage and put lives at risk. Cancer survivors such as Eboni, who was able to recover from non-Hodgkin’s lymphoma behind her eye, would be left without the coverage they need to stay healthy for their families.

Work requirements lead to red tape

The reality is that most adults on Medicaid are already working or face significant barriers to employment. According to a Kaiser Family Foundation report, nearly two-thirds of Medicaid enrollees under 65 are employed, and another 3 in 10 are not working because of caregiving responsibilities, illness, disability or school attendance. Work reporting requirements don’t help people find jobs — they simply push more people into red tape that leads to coverage loss.

In Indiana, that red tape — which also included requirements for people to make monthly payments to the state’s Family and Social Services Administration to demonstrate “personal responsibility” — caused about 60,000 Hoosiers to lose coverage. Grassroots groups such as Hoosier Action jumped into action, collecting petition signatures and making phone calls to lawmakers. Hoosiers deserved better. They deserved care, not administrative hoops to jump through.

Instead of improving Medicaid, these policies punish caregivers, students, workers with unpredictable schedules and people with disabilities and chronic conditions — people already struggling to make ends meet. Medicaid should ensure people can access the care they need, not impose costly barriers that disproportionately harm women, communities of color and low-wage workers.

Beyssa, a single mom in Florida with multiple sclerosis, relies on Medicaid for lifesaving infusions while raising her son, who has autism. Without it, she couldn’t afford the treatments that slow her disease, allowing her to care for her child and work when her health allows.

And let’s be clear: This isn’t an abstract policy debate. For millions of families like Eboni’s and Beyssa’s, Medicaid isn’t just health care — it’s security and survival. The question is simple: Do we take away their care to fund tax cuts for billionaires, or do we uphold a system that ensures families can get the health care they need?