Op-Ed: Care For Constituents Or Chaos? Medicaid Cuts Will Devastate All Of Us
In our country, which has so much abundance, poverty shouldn’t be a death sentence. However, proposed cuts to Medicaid will cause many individuals, families and communities to suffer for that very reason–poverty. Significant and potentially massive cuts to Medicaid will cause irreparable harm. Shockwaves will reverberate in rural, urban, and suburban communities, and impact individuals, working families, many of our most fragile elderly and our most vulnerable young and disabled.
I offer this perspective as a public health practitioner. I have spent my career supporting and advancing health systems in our country, across Louisiana, the Gulf Coast, and in our nation’s capital, Washington, D.C., Medicaid supports our workforce and health systems (hospitals and clinics), in addition to individuals, families, and communities
Medicaid provides insurance to people with low incomes and people who have disabilities. This includes many individuals who work, but still don’t work jobs with health insurance, work part-time, or don’t make enough to cover insurance. It is the nation’s single largest health insurance program. And it is wildly popular.
More than 96% of Americans believe the program is important in their communities and recent national polls from January 2025 found that 80% of Americans have a favorable view of Medicaid.
Some may wonder if I am overreacting. I’m not. More than 70 million Americans receive health care coverage under the Medicaid program. In Louisiana, where I live, one-third of our adult population is on Medicaid, and the percentage of coverage is even higher in rural areas. In fact, Medicaid plays a much larger role in covering rural communities in Louisiana and across our country than it does in metro/areas. In other parts of the South, like rural Kentucky, more than 40% of the population is on Medicaid. These individuals, like all of us, want nothing more than to live healthy and thriving lives while making ends meet for their families and making their children’s futures more prosperous.
The public may envision people on Medicaid as unworthy of receiving assistance. But there is no one profile of a Medicaid recipient. They come from all backgrounds, all races and ethnicities, all ages and all communities. In fact, most low-income Americans, whether rural or urban, Black or White, Republican or Democrat, share an economic fate impacted by hardship, and the solution to their support and prosperity is also shared. For instance, “The number of people earning less than $25,750 for a family of four is rising in both Republican and Democratic districts, and across racial and geographic lines.”
It’s also important to understand the range of services people receive from Medicaid. Services include everything from general health services, to behavioral health (mental health and substance use) services, disability services, maternal health supports and more. Impacts across all of these areas could be devastating with federal and state cuts to beneficiaries or benefits. For example, maternal health outcomes, particularly maternal mortality, continue to devastate families and communities across our country. Louisiana had the nation’s fourth-highest maternal mortality rate in 2021 at 60.9 deaths per 100,000 births, but I know this is not just a Louisiana problem; it’s a national one.
The March of Dimes reported that “870 maternal deaths occurred each year…and every year 50,000 women experience a life-threatening complication (sometimes called a near-miss)” or severe maternal health complication. With such high risk, good coverage and high-quality care is more important than ever, and over 42% of all births in our country are covered by Medicaid. Reducing these Medicaid benefits would be disastrous to mothers, babies and families. Chancing the lives of mothers and babies is simply too risky!
While I referenced maternal health, Medicaid supports the existence of healthier communities. Beyond the immediacy of illness, sick people can’t work, study, or play. They can’t contribute to their families, our communities, and the country’s economy—from kids, to employers, to the GDP, everyone loses.
Our nation’s health systems, from rural health centers to large urban hospital systems receive critical funding to cover the millions of peoples seeking care. The healthcare sector, one of the most important sectors of our economy overall, relies heavily on Medicaid reimbursement to sustain jobs and services. Cuts of great magnitude will threaten clinics, hospitals and medical providers. We will see the impacts of this immediately in rural regions with the shuttering of services, significant job losses, and further diminishing already challenged access to care. With health care shortages already existing, our conversations need to be continued around closing the gaps in access, not creating new chasms.
Now more than ever, we need our leaders and legislative champions to protect our communities and their health and well-being! Given the adverse impact Medicaid cuts would have on the nation, we need to boldly reject proposals that will weaken the program and impact all of our communities.
Given its importance, some may wonder why elected leaders would want to cut the program. Some legislators propose cutting Medicaid as part of a broader plan to give $4.5 trillion in tax cuts. Others want to lower the federal deficit, a $1.1 trillion deficit at the end of February 2025. Policymakers should not attempt to bring down federal spending with ill-conceived strategies that will only add to Americans’ suffering. They should instead think strategically about taxation.
Legislators can bring a great deal of confidence in their leadership by examining other alternatives to drastic Medicaid cuts, by reminding us that they care for all of their constituents, and that they are creating a vision for a healthier future based on their community’s needs—timely doctors’ visits, healthy births, high quality mental health care and substance use supports—not disregarding, or even worse targeting the thing that keeps us safe and well.
Shelina Davis is the Chief Executive Officer of the Louisiana Public Health Institute.
SEE ALSO:
The Midnight Medicaid Cuts: Why The GOP’s Reconciliation Bill Is A Raw Deal For The American People