The GOP Medicaid Massacre Will Destroy American Lives

The plan Republicans have put forth will leave seniors and people in rural areas particularly vulnerable.

The Medicaid Massacre by the House GOP will fittingly take place in the middle of the night. The cowards stripping healthcare from millions of Americans want to slink away into the shadows after screwing all but the richest people across the country.

The wreckage it leaves behind will not be as easy to hide.

Cutting Medicaid will have a cascading effect that will be felt across the entire economy, particularly in rural areas. Eventually it will end up costing far more than saves, not just in lives lost, but in monetary terms. Here is how that happens:

1. Tens of millions of people will lose their health coverage.

Medicaid provides coverage to 83 million people in America. That is just about 1 in 4 who rely on it for their healthcare. The percentages are greatest across the southeast and in Rust Belt states - in other words, the very states that delivered victory to Donald Trump. The GOP plan could cost 36 million of those folks healthcare.

2. Long-term care for millions of older adults and those with disabilities could be cut off.

About 30 percent of Medicaid funding goes to people who are dual eligible for Medicaid and Medicare — that typically means older Americans. Because Medicare does not support long-term, skilled nursing care, most rely on Medicaid to pay the thousands of dollars per month cost. The alternatives for these people are not good. Even those that have family to take them in will not receive the medical care they need on a daily basis.

3. Hundreds of rural hospitals in America will shutter.

Rural communities — many of whom supported Trump — have seen dwindling access to healthcare for the past two decades. Those that still exist have barely kept the doors open. Because a disproportionate number of their patients come from poor, rural areas, they disproportionately rely on Medicaid coverage. The GOP bill will put more than 300 of those hospitals at immediate risk of closure.

Again, the cuts will disproportionately affect southern and Rust Belt states. For example, while only 8 hospitals in California would be under threat, 21 would be slated to shutter in Texas, 12 in Pennsylvania, 10 in Georgia, 8 in Virginia, and 8 in Minnesota.

Those closures will create healthcare deserts — people may need to drive for hours, even across state lines, to get help.

4. Cuts elsewhere will lead to higher costs.

As more people lose their healthcare coverage, it will lead to sicker Americans across the country. They will both delay care and be unable to access it. That in turn leads to more emergent and urgent care visits, the most costly way to treat long-term health concerns.

Additionally, because federal law prohibits hospitals from turning away people seeking care at their emergency rooms, those still open will see a huge uptick in patients with nowhere else to turn. Much of those patients will not have any way to pay and the hospitals will be stuck with the costs. Unfortunately, Medicaid is the safety net for nonpayment through disproportionate share hospital (DSH) payments. When those stop, even less rural hospitals will be affected.

5. State budgets will be crushed.

Medicaid funds flow from the federal government through the states for administration. Cutting the program will put enormous pressure on every state to come up with billions of dollars to backfill the hole. Doing that will require cuts elsewhere.

6. Bankruptcies will spike.

More than half of all bankruptcies in America are the result of healthcare costs. With Medicaid slashed by the GOP, that number will necessarily jump. Families already struggling with rising costs under Trump’s tariffs and mass layoffs will not have the Medicaid safety net to keep them from losing everything after a single medical emergency.

Mario Nicolais is General Counsel for The Lincoln Project. In addition to a law degree, he has an MBA in Health Administration, teaches Health Care Law at the University of Colorado, and served as general counsel for multiple healthcare companies. Follow him on Bluesky: @MarioNicolais.bsky.social.