June 11, 2025
We are facing a national crisis in health care. House Republicans recently passed their budget bill – the cartoonishly named “One Big Beautiful Bill” – by just one vote along party lines. There were no public hearings, and House members were not afforded time to read the bill before they chose to vote on it. This bill would slash funding for all of our most vital health programs: Medicaid, the Affordable Care Act’s Marketplace, and yes – Medicare.
Roughly 15 million low- and moderate-income people would lose health coverage and become uninsured under the House Republicans’ sweeping and draconian health care agenda. Let’s be clear about one thing: there was no electoral “mandate” to cut healthcare programs. No one campaigned on getting rid of your health insurance or on driving up the costs of your health insurance so you end up paying more. So why, then, are these items in the Republican budget bill?
These cuts exist purely for the purpose of helping to pay for massive tax cuts for the wealthy. In other words, this bill would create a massive transfer of wealth from low- and moderate-income people and families, to the wealthiest people and corporations. There is no health policy that can justify these changes.
It is vile, and it is deeply dangerous.
We know that the end result of these cuts to healthcare programs will be that people will live sicker, and they will die younger from preventable conditions. Health insurance is crucial for giving people access to preventive, primary, and specialty care. Early detection and treatment saves lives. Health insurance coverage also helps fund the health care system that we all depend upon. Reducing coverage and creating more uninsured will devastate our healthcare systems.
Senator Jodi Ernst (R-Iowa) spoke the quiet part out loud when she expressed callous disregard for the impacts of this bill. At a rare Town Hall meeting in Iowa, when confronted by frightened constituents who fear that the Medicaid cuts could be fatal, Senator Ernst made light of her constituents’ concerns by saying “we are all going to die.” This callous and glib response is the sort of answer one might expect from a psychopath, and indicates that she does not care about quality of life for those who will suffer. Shame on her. Unfortunately, Sen. Ernst is clearly not the only member of Congress who has this attitude. In fact, this attitude of cruelty and disinterest is reflected in the House Republicans’ budget bill and their priorities for funding cuts and tax breaks.
Below is information about some of the provisions of this dangerous budget bill, and what’s next in the process and how you can help.
Medicaid Cuts: The single biggest Medicaid cut in dollar terms is an extreme work requirements provision that would take away coverage from low-income adults enrolled in the Medicaid expansion group made possible by the Affordable Care Act (ACA) who cannot document meeting rigid work requirements or show they qualify for an exemption. The provision as passed by the House would take effect no later than December 31, 2026, but states would have the option to implement work requirements even earlier.
People subject to the requirements would have to be employed to enroll in Medicaid, posing real barriers to people who get laid off and lose their employer health coverage or people who are ill and need care to get better and find work. Even worse, it gives states the option to adopt an unlimited “lookback” period, meaning they could require people to report work hours far back into the past — could be months or years — as a condition of qualifying for Medicaid.
The truth is that a majority of people with Medicaid who can work, already do. And here is another truth that those seeking to gut Medicaid under the guise of “work requirements” don’t want you to know: these requirements create bureaucratic red tape at the state level that leads to people losing coverage while increasing administrative costs to states, and to you, the tax payer.
We have seen it happen before. In Arkansas, the first state to implement Medicaid work requirements in 2018, over 18,000 people lost their coverage in just the first few months of implementing the requirement. Most were dropped not because they failed to meet the work threshold, but because the state’s reporting process didn’t work well.
Arkansas saw no measurable increase in employment – only an increase in the numbers of uninsured. And this policy cost taxpayers over $26 million in administrative costs to manage the work requirements system.
Also, consider this, in light of all the recent and ongoing climate-related natural disasters: If a community is devastated by flooding or hurricanes, businesses often have to shut down and people lose their jobs. That’s exactly when Medicaid should be available to step in an cover the gaps. But under the new provisions in the House Republicans’ budget bill, Medicaid would not be able to function in this capacity, as it has for decades.
Increasing premiums and cost-sharing for ACA Marketplace enrollees: Another element of House Republicans’ health agenda targets the ACA marketplaces, which provide coverage and financial assistance to more than 22 million people. The marketplaces, which started in 2014, are a critical source of coverage for those who lack health benefits at their jobs, such as self-employed people, low-paid workers, and older people not yet eligible for Medicare. The marketplaces’ enhanced premium tax credits that make marketplace health plans affordable, would go away under this bill.
Medicare and the programs that help make Medicare affordable: Certain people will lose their Medicare coverage with changes to Medicare eligibility, including permanent residents of the U.S. who have worked and paid into the Medicare system. Additionally, the bill would make it harder for low-income Medicare beneficiaries to qualify for the Medicare Savings Program, which provides Medicaid coverage to help pay for monthly Medicare premiums and co-pays.
Nursing home staffing levels: A CMS rule from 2024 requires long-term care facilities to meet minimum staffing levels for patient safety. Now, this Republican bill will prohibit the Secretary of Health and Human Services from implementing or enforcing this rule, so staffing levels will remain dangerously low.
SNAP (food stamps) cuts: While the focus of this letter is on health programs, it is also worth mentioning that the House Republican bill also includes massive cuts to SNAP, and it is estimated that approximately 4 million people will lose their SNAP benefits and face hunger and malnutrition.
What’s next, and how you can help: The Senate will now be considering the awful House budget bill or potentially developing their own bill. The Republican-led Senate has already stated that they will not be holding hearings on their budget bill. Ultimately, the House and Senate versions of the budget bills will have to go through a “reconciliation” process to come up with one budget bill. Trump has set a deadline of July 4, 2025 for finalizing the budget bill.
You can help by contacting your Senator: The time is now to start contacting our Senators and telling them to oppose the House budget bill and all the cuts to Medicaid, the Marketplace, and Medicare, as well as SNAP. You can look up your Senators’ names and phone numbers and call their office directly, or you can call the United States Capitol switchboard at (202) 224-3121. A switchboard operator will connect you directly with the Senate office you request.
You can also help by sharing this message with your friends and family, wherever they live. We need as many people as possible across our community and our country to a) get informed; and b) take action! You can help by sharing this information with them.
In 2017 and 2018, Champaign County Health Care Consumers (CCHCC) mobilized our community to join the nationwide efforts to protect the Affordable Care Act (ACA) and Medicaid, from being repealed, block-granted, and dismantled, protecting care for millions of Americans.
Unfortunately, the fight to protect our care is not over – there are new and greater threats to Medicaid, the ACA, and Medicare – and CCHCC needs your ongoing involvement and support to protect these programs, and to help ensure that everyone who turns to CCHCC for help getting access to health care and coverage gets the help they need.
When we stand together, we are strong! You can count on CCHCC to lead the fight locally, but we can’t do it with you.
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We thank you for your commitment, and for your ongoing support and involvement!
Sincerely,
Claudia Lennhoff
Executive Director
Champaign County Health Care Consumers