Opinion: Proposed budget cuts to Medicaid will harm all of us

A Michigan physician warns of the wide-reaching impacts of Medicaid cuts.

Medicaid cuts written into the “One Big Beautiful Bill” will affect us all. For some bureaucrats, Medicaid is a line in a spreadsheet. For many of us, however, it represents much more. As a physician, I understand the impact of the cuts through my patients. These are some of their stories.

A 26-year-old with severe mental health issues aged out of his parent’s insurance. His condition is controlled with a complex regimen of seven medications, which he cannot afford out of pocket (over $250 a month). The prescriptions and necessary lab monitoring are the difference for him between being disconnected from reality and living a normal, young adult life. With them, he lives independently and is fully employed at a community youth center. Since his adjusted gross income is below 133% of the federal poverty level, he is eligible for Medicaid. 

He is one of many who work full-time and cannot afford private insurance. Medicaid, rather than enabling laziness as the GOP has suggested, actually allows him to be a productive member of society, who pays rent and participates in the local economy. Untreated, his illness carries the risk of psychosis, hospitalization, or even suicide. 

Then there is the story of a mother holding down a minimum wage job. Her income qualifies the family for Medicaid benefits. This allows her two special needs children to receive the services required to remain at home with her and not in a more expensive institutional setting.

People with chronic illnesses and special needs are not the only people on Medicaid in Michigan. Over one quarter (27%) of the 2.7 million people in Michigan are on Medicaid.

Many—44% of adults under age 65—on Medicaid are employed and participate in the state economy. An additional 20% work part-time. These are hardly freeloaders.

Medicaid coverage also includes preventative care: dental, vision, immunizations, pap smears, and chronic disease management. Primary preventive health measures reduce the overall cost of healthcare expenditures. If one quarter of Michiganders lose access to preventive care, it will significantly increase the state’s burden of chronic disease. People will still have strokes, heart attacks and accidents, and hospitals will treat them. 

Since 27% of the population is covered by Medicaid, cuts to the program will impact the payor base as well. Expensive, specialized care for those no longer covered will become uncompensated care. Hospitals facing an increase in uncompensated care will pass the financial burden on to paying customers, driving up the already exorbitant costs for those who are insured. Paradoxically, people skipping preventive services may decrease the jobs of  some of the one million Michiganders employed in the healthcare sector.

Medicaid does much more than reduce medical costs for low-income recipients. It also funds post-graduate medical education for specialties of which there are shortages. Locally trained physicians are more apt to remain in Michigan to practice. Cutting local training opportunities will limit the supply of much-needed specialties reducing the level of care statewide.

In short, the cuts will harm Michigan at multiple levels. Up to one-quarter of the population may lose access to care. Participation in the state economy as workers and consumers will decrease. Hospitalization rates of profoundly mentally ill citizens will increase. Statewide healthcare costs will rise through decreased access to preventive and primary care and an increase in uncompensated care.

Proposed budget cuts to Medicaid will harm all of us. Please take action before it’s too late. The Senate plans to hear the bill before July 4.  Contact your Senators, Elissa Slotkin and Gary Peters, to help them understand the citizens of Michigan don’t belong in a spreadsheet.

Related: Report: Trump-backed Medicaid cuts to strip health care from 500,000 Michiganders