There has been a constant battle for Medicaid in America – from states slashing Medicaid reimbursements or refusing to expand access, to Congress now threatening to cut and restrict Medicaid funding altogether. The program, which funds 78.4 million of our most vulnerable patients, is a necessity to primary care. Medicaid beneficiaries look like pregnant women needing prenatal care. Children requiring early intervention to reach developmental milestones. They are people facing homelessness who need diabetes management to avoid hospitalization. Those with disabilities who cannot afford prosthetics after amputation with their current coverage plan in a non-expanded state.
These are the faces of Medicaid – nearly 1 in 5 Americans, ranging from children, pregnant individuals, the elderly, those with disabilities, and our unhoused neighbors. Cutting or underfunding this program doesn’t just trim a budget line but denies essential, often life-sustaining care to those already living on the margins.
Call for Advocacy
Many leading medical organizations, including the American Academy of Family Physicians (AAFP), are urgently calling on Congress to protect Medicaid from funding cuts. As frontline providers, family physicians deliver comprehensive care across the lifespan, “from cradle to grave.” Each and everyday we witness the critical role this bedrock program plays in improving access, outcomes, and stability for our patients. As a resident physician of Family Medicine in Texas, I know firsthand how cuts to Medicaid impact not just the patients but also entire healthcare systems.
I work in Texas, which is one of 10 states that have not yet adopted Medicaid expansion. Without expansion, many working Texan families fall into a “coverage gap” where they make too much to be eligible for federal program coverage, but too little to afford private insurance. With 42% of the nation’s coverage gap population, Texas leads all states in leaving low-income adults without affordable health coverage.
Public Sentiment about Medicaid
The public shares a similar sentiment, despite political party affiliation, with 97% of Americans believing Medicaid to be important for their local communities and 56% believing it to be important for their families. Nearly 53% of Americans state they themselves or a family member have been funded by Medicaid at one point in their lives, underscoring the program’s broad reach. For Texas specifically, recent polling by the Barbara Jordan Public Policy Research and Survey Center at Texas Southern University indicates that 51% of Texans favor expanding Medicaid access. This remains consistent with 2023 polling by The University of Texas, in which 73% of Texas voters supported Medicaid expansion.
The Successes of Medicaid Expansion
It is clear that Medicaid expansion increases access to healthcare and thus improves overall health outcomes. This includes decreasing maternal and infant mortality rates, which should be of particular interest to Texas as the state’s maternal mortality rate is among the highest in the country and continues to rise. Expansion has been found to offset healthcare costs not just by improving hospital compensation, reducing emergency service usage, and increasing federal funding, but also by improving the financial security of beneficiaries. Reducing medical bills has a powerful ripple effect on the financial well-being of our society, for example, by leading to better credit scores and decreasing housing insecurity. A recent blog post further highlights the diverse impact of Medicaid funding including addressing homelessness, providing healthcare in rural areas, increasing access to dental care, and even ensuring the financial stability of the healthcare industry e.g. Medicaid Managed Care Organizations (MCOs).
What happens next?
In alignment with The Medical Care Blog’s 2025 theme, “Political Determinants of Health,” healthcare providers must continue to advocate for the protection of Medicaid and confront the potential harms of inaction through a Health in All Policies framework. Funding threats are setting in motion a cascade of consequences policymakers will not be able to ignore for long, including worsening health inequities, rising emergency care costs, poorer health outcomes, and an erosion of the primary care workforce. In this crucial moment, policymakers must listen to frontline healthcare providers and the patients they serve to protect Medicaid.
Emma DiFiore