Soon after Trump’s re-election, it became clear that Republicans would target Medicaid for cuts as a way to finance tax cuts for the wealthy. The House recently approved the bill containing those cuts and it’s now winding its way through the Senate. The Senate usually acts as a moderating check on the partisan tendencies of the House, but that doesn’t seem to be the case this time. The Senate version of the bill makes even deeper cuts to Medicaid by imposing a stricter version of the work requirements that passed the House. It also places tougher restrictions on the tools currently used by states to fund their Medicaid programs (if you have a burning desire to learn about provider taxes, here is a good explainer). In short, these would be the deepest cuts to Medicaid since its enactment in 1965.
I’ve seen some comments on social media from people with disabilities that are dismissive of the cuts because they don’t explicitly target us. This is a bad take because it fails to understand the practical consequences of these cuts. Federal funding for Medicaid will be reduced by hundreds of billions of dollars, leaving states with holes in their budgets that need to be filled somehow, either by raising taxes or reducing services and payments to health care providers. Raising taxes is probably a nonstarter for most legislators, so that leaves service and rate cuts. When those legislators start hunting for savings, they are sure to notice that home and community-based services are a significant chunk of states’ Medicaid budgets.
These comments are frustrating because they play into the trap that the GOP has set for people with disabilities and other marginalized groups. They want us to fight each for the scraps of a tattered safety net. Our infighting keeps us distracted while confusing the general public. The only effective way to fight these cuts is to present a united front representing everyone who depends on Medicaid for health care.
But the opposition to the One Big Beautiful Bill Act (that is the actual title of this terrible legislation) seems disjointed and maybe even a little sleepy. I’m sure a lot of groups are fighting behind the scenes, but I was hoping for more visible protests and more urgent media campaigns, much like what we saw during the failed effort to repeal the Affordable Care Act in 2017. There is still time for that to change. The House will have to pass whatever the Senate sends back to them. I just hope that we aren’t resigning ourselves to watching these draconian cuts become law.
