The following story comes from ThreeSixty Journalism, a multimedia storytelling program for diverse Minnesota high school students focused on contributing to more accurate narratives and representative newsrooms.
A budget blueprint passed by House Republicans this week includes steep cuts to Medicaid, which could leave millions of people without health care.
Medicaid, a public health insurance program for low-income individuals, provides coverage for over 80 million Americans, ensuring vulnerable people have access to medical care.
It is jointly funded by federal and state governments, with the federal government typically contributing 70% of the costs; however, it is contingent on how much each state allocates or their residents’ income levels. For states that expanded Medicaid under the Affordable Care Act (ACA), the federal contribution reaches as high as 90%.
Dr. Nathan Chomilo, medical director for Minnesota’s Medicaid and MinnesotaCare programs, says the program touches all Minnesotans: “There’s someone in your life, whether it’s a family member, a friend, a friend of a family member, … [who] has had Medicaid step in and help them,” he said.
Medicaid is a lifeline for millions of Americans who can’t afford the care they need, including physician services, labs and X-rays. Providing medical services such as immunizations and screenings helps prevent more serious, costly health issues. Health insurance through Medicaid works to ensure Americans stay healthy, go to work, care for their families and pay their bills.
Susan Pleasants, senior vice president at M Health Fairview and a practicing physician, believes Medicaid is crucial for ensuring vulnerable communities have access to insurance.
“The people who are most impacted are communities like the disabled who have nothing going for them as far as services or benefits, so Medicaid is really their access for almost everything that supports their daily life,” Pleasants said.
Medicaid was relatively stable under both the Obama and Biden administrations. President Donald Trump’s recent endorsement of a U.S. House budget that would gut Medicaid, despite previously stating the program “isn’t going to be touched,” has raised concerns about the future of the program.
During his first term, Trump’s attempt to impose block grants or per capita caps alarmed advocates and patients. Now, many are watching as Trump’s conflicting plans for the future leave Americans unsure if he will pursue actions similar to his last term, potentially impacting millions who depend on vital health care resources.
Sarah Rahmoune, a freshman at the University of Minnesota, says using Medicaid has made health care affordable for her. “We would probably struggle paying for health care if it wasn’t for UCare or Medicaid. Just a doctor’s visit itself is pretty expensive … because of Medicaid, we don’t have to pay as much every time we get sick,” Rahmoune said.
In Trump’s previous term, his administration invited states to sign waivers changing their Medicaid programs into a block grant, which caps federal funding, limiting coverage and benefits. The administration also attempted to lower the income threshold for Medicaid eligibility.
Adrian Uphoff, health policy analyst at the Minnesota Medical Association, says the threatened cuts overlook the impact of Medicaid. “The push for fiscal conservatism in health policy often overlooks the realities of how health care access and affordability are tied to basic human needs,” Uphoff said.
Uphoff believes the Trump administration will likely face backlash from its bipartisan supporters if major changes are made.
“I think the administration may come to find that Republicans in Congress are going to be upset when their constituents come knocking on their door saying, ‘Why can’t I get health care anymore?’” Uphoff said.
As voters in rural populations increasingly align with the Republican Party, cuts to Medicaid would disproportionately impact these regions, potentially leading to hospital closures and limiting access to health care for residents outside of the metropolitan areas, regardless of political affiliation.
Chomilo shares Uphoff’s concern about the possible impacts of these shifts, “If things like work requirements and per capita caps are implemented, I think we can expect to see more challenges for individuals who rely on Medicaid, increasing the strain on both the state and on vulnerable communities,” Chomilo said.
“We’ve seen in other states like Arkansas and Georgia that work requirements didn’t lead to greater employment but did lead to an increase in medical debt and a decrease in access to care,” he said.
“Medicaid is really the backbone of so much of our health care system … so many children and families who have had some misfortune and might find themselves disabled at the moment are depending on Medicaid to be there for them to support them … I really do believe we all do better when we all do better, as late Senator [Paul] Wellstone once told,” Chomilo said.
Minnesota congressional and state lawmakers denounced the proposed cuts, and plan to hold a press conference on Thursday alongside health care advocates to discuss the possible effects of the GOP budget plan.
Sahan Journal health reporter Mohamed Ibrahim contributed to this story.
