In politics, sports and life, some decisions matter and some don’t. In a football game, a bad call in the first quarter probably doesn’t matter much, but a blown call late can change the outcome.
It’s the same with federal policy. Many new-administration initiatives have garnered headlines but won’t matter much. Renaming a body of water? Reinstating plastic straws? Changing the name of Fort Liberty back to Fort Bragg (but with a different Bragg)? None of those actions will matter to the everyday lives of most Americans.
Yet, Congress is considering changes that will seem late in the game for tens of millions of Americans at risk of losing healthcare.
As lawmakers in the House of Representatives consider their budget, they are weighing whether to cut spending on Medicaid. This program provides critical care for 72 million low-income Americans, including children, seniors, veterans and people with disabilities. It is the largest single source of health coverage for Americans. That would be the wrong call. Medicaid is not the place to go looking for budgetary savings.
According to the health research firm KFF (formerly known as The Kaiser Family Foundation), 25 percent of Americans — 80 million people — get their healthcare through Medicaid. Knowing this makes the program seem fairly efficient since it covers one-fourth of the population but accounts for only one-sixth of national healthcare spending.
Medicaid ensures that poor people in red states have access to essential medical services, and it is a significant source of funding for hospitals and nursing homes. That makes it wildly popular. One poll this year found that three-fourths of Americans have a positive view of Medicaid. No politician comes close to that approval rating.
The program is especially popular in the states where Republicans won the most votes in 2024. “In the seven states that have had ballot initiatives on Medicaid expansion, it’s won with striking margins,” Politico reported. “That includes deep-red places like Idaho and Utah.”
“The expansion of Medicaid has helped a lot of people around here, including myself,” Frances Trice of Hazard, Kentucky, told the American Heart Association. “There would have been absolutely no way I could have afforded everything I had to have done.” She needed open-heart surgery.
Before Medicaid was expanded, the hospital where Trice was treated struggled to make ends meet. “We were providing services to people who couldn’t pay for them,” medical director Key Douthitt said. “We know (Medicaid’s) improved our patients’ lives.”
Medicaid pays more for the treatment of opioid and other substance abuse than any other program, and it pays to help people fight mental illnesses that often lead to substance abuse. It provides healthcare to the disabled, adults and children, who couldn’t qualify to purchase insurance anywhere else. It’s also the single largest payer for nursing homes and long-term care, the sort of services that even middle-class Americans need.
President Trump seems to realize that slashing Medicaid is a bad move. His administration is going to “love and cherish” Medicaid, Trump told reporters last month. “The people won’t be affected. It will only be more effective and better.”
Medicaid has a 77 percent approval rating across partisanship, race, ethnicity, vote choice and income level. There was a bipartisan outcry when the administration briefly locked Medicaid out of the federal health payment system last month.
“Medicaid, you got to be here because a lot of MAGA is on Medicaid,” longtime Trump adviser Steve Bannon said. “Medicaid is going to be a complicated one. Just can’t take a meat axe to it.”
Lawmakers should heed those warnings. Medicaid, like all federal programs, can be improved — incrementally. However, slashing hundreds of millions from the program wouldn’t improve it or benefit constituents. Doing so would only endanger millions of American voters. Lawmakers should protect Medicaid and improve the program, not recklessly cut it.
Trump promised Americans that he would protect entitlement programs. Congress should heed the president’s wishes.