In a move that could rip health coverage from nearly 9 million Americans, the House of Representatives has passed its budget bill, which includes major cuts to the Medicaid program. Much of the debate, from critics on both sides of the aisle, has focused on the harm this could cause the most vulnerable Americans. There’s good reason for that: Medicaid recipients are largely low-income, disproportionately Black and Hispanic and many are disabled or pregnant.
But Medicaid is more than just a safety net for its recipients. It’s a cornerstone of our nation’s well-being. A strong Medicaid system is an engine that powers our economy, sustains our communities and shapes the future of America. Weakening it would not just be a policy change—it would be a reckless gamble with our nation’s stability and prosperity.
First, we can look at the financials: When Medicaid is fully functioning, it can stabilize our economy. In fact, some research has found that expanding Medicaid can actually save states money. When states invest in Medicaid expansions, they often end up offsetting those costs—usually with money they otherwise may have spent on mental health and substance abuse treatment, heath care for incarcerated people or uncompensated care for people who are uninsured. Arkansas, for example, increased Medicaid benefits for pregnant people, and saved over $15 million—slashing their spending in half. Expanding Medicaid can also create economic activity and even boost total employment—which is partly why, as I wrote back in March, the vast majority of states have elected to do it.
If Medicaid is slashed, the economic fallout will ripple through every corner of the country. An estimated $113 billion in state GDP could vanish, and more than a million Americans will lose their jobs in health care, food services, and other vital industries. These aren’t just numbers—they’re the people who look after your children, care for your elders and provide your health care.
When Medicaid is cut, the costs don’t disappear—they get passed on to you. Hospitals will raise prices for privately insured patients to cover the losses from uninsured ones, driving up your medical bills. Meanwhile, rural hospitals—already on the brink of collapse—will close their doors, leaving entire communities without access to emergency care.
In addition, care will likely diminish in quality and quantity—especially in rural America. Individuals in rural communities are more likely to be covered by Medicaid than those in cities—and rural hospitals rely on Medicaid reimbursement just to stay afloat. As is, nearly half of rural hospitals are operating at a loss. If millions of Americans lose their coverage, and show up in rural hospitals and emergency rooms unable to pay, these already-struggling care centers will have to make impossible choices. Even if they charge other patients more, they may still be forced to reduce staff, limit services or potentially shut their doors altogether.
The result: Many Americans may pay higher prices for worse care. Even those with private insurance.
Medicaid is the foundation for millions of American futures. Nearly half of all children (37 million) rely on Medicaid, with 40% of births covered, and closer to 50% in rural communities. This system ensures that kids have the health they need to succeed in school, pursue their dreams, and build the future of this country. Without it, we risk stunting the potential of the next generation of innovators, leaders and citizens.
While Medicaid is critically important to the health of our nation, it is not without flaww, nor is it impervious to reform. Critics are right to worry about Medicare and Medicaid fraud—these systems saw roughly $100 billion in payment errors in 2023. But taking away health care coverage for millions of Americans will likely not fix that fraud or recoup those funds. There are existing proposals that could—and some have already proven successful.
No matter your politics, Medicaid’s impact is undeniable. Medicaid doesn’t just change lives—it saves them. Research shows that 27,400 Americans are alive today because of the program. Without Medicaid, roughly one-fifth of the American population would not have health insurance. That is nearly 80 million people who now can get the health care they need—whether that be cancer treatment, a stay in the emergency room or a safe place to give birth.
We all have a stake in protecting Medicaid. You may not be a Medicaid recipient, but you likely interact every day with people who are. That could include the childcare worker who cares for your children while you are at work, the cashier who rings up your groceries, the construction worker who builds your home or the barista who serves your morning coffee. Medicaid isn’t just about those people—it’s about all of us.