Protecting the Vulnerable: What’s at Stake with Medicaid Cuts

Author: Dr. Shakira J. Grant

Date: April 9, 2025

Millions Rely on Medicaid. Slashing $880 billion Would Gut a Lifeline.

Medicaid isn’t just a health insurance program it’s the backbone of care for 1 in 5 Americans—nearly 72 million people. The majority of those who depend on Medicaid are 65 years and older, have intellectual or physical disabilities, or live on low incomes. Medicaid enrollees not only depend on this critical service for doctor visits and medications, but to also address the social determinants of health (SDoH) that limit access to health care and result in poor health outcomes. From transportation to appointments and home health aides to caregiver relief and food assistance, Medicaid addresses the real-life barriers that determine whether someone gets better—or falls through the cracks.

With 80% of health outcomes shaped by social and economic conditions, cutting Medicaid is more than a budget decision—it’s a direct threat to the health and stability of millions.

A Man Sleeping on a City Bench

The Backbone of Long-Term Care

Medicaid is the largest payer of long-term care services in the U.S., covering more than half of all nursing home residents.

For millions of families, Medicaid is the only option to afford around-the-clock care for aging or disabled loved ones. Without it, long-term care becomes inaccessible, unaffordable, or simply unavailable—especially in rural and underserved communities.

Hospitals and Workers on the Front Lines Will Feel the Strain

Medicaid dollars help keep safety-net hospitals afloat and support a critical segment of the health care workforce.

States rely on Medicaid revenue to maintain essential services, and providers depend on it to offer care without turning patients away. If funding is cut, hospitals—particularly those in rural and underserved areas—may face impossible choices: reduce services, cut staff, or shut down altogether.

States Like Mississippi Face Outsized Risks

Some states will bear a heavier burden from Medicaid cuts—especially those that haven’t expanded the program under the Affordable Care Act.

Mississippi is one of the most vulnerable. The state has the lowest life expectancy in the U.S. (71.9 years), along with the highest poverty rates, infant mortality rate, income inequality, and some of the worst health outcomes, and racial health disparities in the country.  To sustain its Medicaid program, Mississippi relies heavily on federal support—receiving 77 cents for every dollar spent by the state on Medicaid through the Federal Medical Assistance Percentage (FMAP).

If federal funding is reduced, the state would be forced to shoulder a much greater share of costs—an almost impossible task for a state already struggling economically. Cuts would limit the ability to care for residents with chronic conditions, hinder investments in preventive care, and exacerbate gaps in access. The ripple effects wouldn’t stop at health care—Mississippi could face even deeper economic instability, with lasting consequences for both public health and the state’s overall well-being.

The Human Cost: A Hypothetical Scenario

Imagine a 53-year-old woman in rural Mississippi with a debilitating illness and no nearby family.

Unable to drive and unemployed due to her condition, she qualifies for Medicaid and relies on it for home-based services, transportation to her doctor, and medication. Without Medicaid, she would lose access to nearly every form of support keeping her alive and stable.

Public Support for Medicaid Remains Strong

Americans across the political spectrum continue to support Medicaid as a vital safety net. According to a 2025 poll by KFF, 77% of adults view Medicaid favorably, including 84% of those currently enrolled in the program. Participants emphasized how Medicaid helped them afford medications, access care during difficult times, and maintain their overall health. Many also recognized the broader connection between health, the ability to work, and economic growth.

Far from being a niche program, Medicaid has proven to be a unifying force—one that bridges political divides and reaches into every community. Its wide-reaching benefits underscore that this is not just a program for “others,” but a foundation of stability for millions of Americans at vulnerable moments in their lives.

What About SNAP? A Parallel Lifeline at Risk

The Supplemental Nutrition Assistance Program (SNAP) provides food aid to over 41 million Americans—or 1 in 8 people in the U.S.

Like Medicaid, SNAP is designed to support the most vulnerable: low-income families, children, older adults, and people with disabilities. Managed by the USDA, SNAP ensures food access and reduces food insecurity, which is a major contributor to poor health outcomes. Cuts to SNAP—often proposed alongside Medicaid reductions—would compound harm by undermining another core support system for the same populations.

The Economic Ripple Effect

Combined cuts to Medicaid and SNAP could cost the economy over 1.3 million jobs and slash $1.1 trillion in economic activity over a decade.

According to the Commonwealth Fund, proposed cuts would mean a $95 billion loss in federal funding by 2026 alone, a $113 billion drop in state GDP, and $8.8 billion lost in state and local tax revenues. These programs don’t just support people—they support economies, particularly in states already facing economic distress.

A Question of Priorities

Is cutting $880 billion from Medicaid truly a cost-saving measure—or a shift that will cost us more in the long run?

The reality is that slashing core support programs doesn’t eliminate need—it just shifts the burden. Emergency rooms, schools, and social services will face surges in demand, often at a higher cost and with fewer resources.

The Call to Action

As lawmakers weigh the future of programs like Medicaid and SNAP, the question is not just fiscal—it’s moral.

Now is the time to ask: Who are we willing to leave behind? Maintaining these safety nets is not only about health and hunger—it’s about preserving human dignity and protecting the foundation of a stable society.

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