Congressional Republicans are disingenuously presenting their $880 billion Medicaid cut in the budget reconciliation bill as an enormous savings to Americans. But this cut in federal health care spending will have very different repercussions for all Americans, regardless of whether they have Medicaid, Medicare, or private insurance.
The GOP’s “one, big, beautiful bill” will kick 8.6 million Americans off Medicaid, leaving them no recourse but to forgo medical treatment or go to hospital emergency rooms — absolutely the most expensive way to deliver care in America. We know from experience that most will choose the emergency room if they have no insurance.
The Republican plan will also reduce access to health care when hospitals close, and worse health outcomes when people delay care. The National Rural Health Association warns that “drastic cuts…will force many rural facilities to reduce or cut service lines or close their doors entirely, impacting access to care for everyone who lives in the community.” If fewer people seek medical help in the early stages of an illness or injury for even a short period, diminished patient flows will put safety net hospitals at risk for closing. If these facilities close, many Americans, particularly in rural parts of the country that voted heavily for President Trump, will be harmed.
Some House Republicans were so concerned with the threat to “the viability of hospitals, nursing homes, and safety-net providers nationwide,” they sent a letter to House Republican leadership. The letter acknowledged, “Many hospitals — particularly in rural and underserved areas — rely heavily on Medicaid funding, with some receiving over half their revenue from the program alone. Providers in these areas are especially at risk of closure, with many unable to recover.” Despite these dire concerns, Trump demanded their compliance, and eventually they capitulated.
The U.S. is already an outlier compared to similarly wealthy countries, spending nearly double per capita on health expenditures than the average of other similar countries. Switzerland is the closest in per capita spending at $9,688 compared to the $13,432 the U.S. spends. The U.S. spends a larger percentage of its GDP on health expenditures as well. Despite spending so much more, the U.S. has lower life expectancy, higher age-adjusted mortality rate, and a higher premature death rate. In the U.S., 26.8 patients out of every 100 patients skip a medical appointment due to cost, compared to an average of 7.0 in comparable countries. It is unacceptable for the U.S. to be falling this far behind. Congress needs to address this gap, but kicking millions off of Medicaid is not the way to do it.
Instead of reforming the system to reduce inefficiencies and drive down costs, Republicans are imposing changes that will force the middle and working classes to pay more. Health care, a necessity that already eats up too much of the average working family’s income, is therefore slated to become even more expensive — all so the rich can enjoy a tax cut.
