How Medicaid Cuts Could Leave Millions Without Health Care in the U.S.
With Medicaid being threatened by the current administration, it is imperative to recognize its importance in the fight for health equity.
Posted on Jan 30, 2025

The United States’ health system is plagued by a lack of affordability, unequal access, and underinvestment in primary care and prevention. For nearly 80 million Americans, Medicaid is a critical solution—a source of access to care and financial protection that would otherwise leave people across the country extremely vulnerable.
The mission of Partners In Health United States, or PIH-US, is to build strong, community-led public health systems that ensure everyone can exercise their right to health. Medicaid is critical to making this a reality by funding many of the community health programs that PIH-US supports. PIH-US also works with partners across the United States to advocate for coverage for the folks who need it most.
With Congress and the new administration considering devastating cuts to Medicaid, we met with PIH-US team members Lucas Allen, advocacy lead of federal and state policy, Ali Bloomgarden, senior manager of advocacy engagement, and Khadija Gurnah, senior director of advocacy, to learn more about the program, its importance, and how to preserve this vital source of health care in our communities. Below, summarized, are their responses:
What is Medicaid?
Medicaid is a public health insurance program that provides health coverage to about one in five people living in the U.S., including eligible low-income adults, working families, children, vulnerable seniors, and people with disabilities.

It was established in 1965 as a federal-state partnership, meaning each state runs its own Medicaid program—sometimes with a unique name like MassHealth, SoonerCare, or Medi-Cal. However, the federal government holds the key to determining country-wide health care standards and funding.
How important is Medicaid to health in the U.S.?
Medicaid keeps people healthy at all stages of life.
- 40% of all births in the U.S. are financed by Medicaid and that percentage is higher for Black (64%) and Hispanic (58%) women and birthing people.
- Medicaid provides coverage to 2 in 5 children, and nearly 3 in 5 nursing facility residents.
- It is also the largest payer of behavioral health services, encompassing mental health and substance use disorder treatments.

Beyond the statistics, Medicaid allows families to seek the care they need without fearing overwhelming health care costs on top of already limited household budgets. It enables financial security and peace of mind.
Compared to those without insurance, people with Medicaid are also more likely to feel empowered to access primary and preventive care services essential to reducing outbreaks and keeping broader communities healthy.
How is Medicaid being threatened?
Key leaders in Congress are actively considering proposals that would slash Medicaid coverage. Republican majorities in the House and Senate are beginning work on major legislation that would provide tax cuts to disproportionately benefit the wealthiest folks in the country. The Treasury’s Office of Tax Analysis estimates that the top 0.1% of earners would get a tax cut of $314,000 under a full extension of the individual and estate tax provisions, with the total cost of those tax cuts amounting to $4.2 trillion between 2026 and 2035.
In order to pay for those tax cuts and cover that trillion-dollar gap, Congressional leaders are considering cuts to vital health programs, including Medicaid. While the specific proposals being considered vary, they would all reduce health funding and make clinical services less affordable, directly harming the millions of Americans who presently benefit--and often survive--due to these programs.
Who would be harmed if Medicaid was cut?
The answer is, likely, all of us. The impact of national cuts to Medicaid funding would be felt in our economy, our states’ budgets, and our communities. Medicaid is the largest source of federal funding to states and is critical for keeping hospitals and clinics afloat.

More specifically, 36.8 million children, 7.2 million seniors, 8.4 million adults with disabilities, and 13.9 million people with mental illness or substance use disorders receiving health insurance through Medicaid would be harmed. Depleting federal Medicaid funding would force state programs to restrict eligibility and reduce services, removing care from those who need it most.
Community health worker (CHW) services might be among the first to be affected. At a time when CHWs are already struggling to sustain funding for their critical work, cutting Medicaid could threaten their hard-fought progress in advocating to be recognized and integrated into Medicaid programs.
Moreover, Medicaid cuts will particularly harm those who already face injustice and oppression. Entrenched racially discriminative systems have created barriers to wealth-building and job opportunities with employer-provided health insurance—driving people of color to disproportionately use Medicaid for their health coverage. Targeting Medicaid reinforces the idea that some lives matter less and that health is a privilege, beliefs that PIH has been fighting for decades.
In response to the concerning shifts we have seen, PIH recently joined almost 350 organizations in signing a letter led by our partners at Families USA, calling on Congress to protect Medicaid. The administration might be changing, but our work will not. We resolve to continue pushing for constructive improvements to Medicaid—such as the Community Health Worker Access Act—while opposing attempts to disinvest in the health of our communities.
What can I do to help save Medicaid and protect the health of nearly 80 million Americans?
Tell your members of Congress to protect Medicaid and oppose policies that would cut this vital program as soon as possible before this legislation is completed. PIH-US has created a template to make reaching out easy.
Congress has considered defunding Medicaid before, and it’s always been the resolute voices and stories of advocates and community members that have protected it.
Your voice—and the voices you bring along with you—will make the difference. Together, we demand health care for every single person.
Contact Congress
Call on your representatives to oppose cuts to Medicaid, a vital program to millions of Americans.