Doctors Warn Medicaid Cuts in Senate Budget Bill Will Kill Their Patients

Senate Republicans are under mounting pressure from doctors and medical associations to reject massive cuts to health care and food assistance as they rush to complete a draft of the budget reconciliation bill designed to implement President Donald Trump’s agenda. Despite an ongoing debate over deep cuts to Medicaid — cuts experts say would devastate already underfunded health systems. especially in rural areas — Senate Majority Leader John Thune (R-South Dakota) pushed this week to put the so-called “big, beautiful bill” on the president’s desk by July 4.

The Senate GOP is looking to make $1 trillion in cuts to federal health care programs over the next decade, including Medicaid, which provides health insurance to lower-income families and people with disabilities. Deep cuts to food assistance for millions of people are also on the table as lawmakers look for ways to cut spending on the Supplemental Nutrition Assistance Program by pushing costs onto states.

“If Medicaid is cut, my patients will die. I realize I am being dramatic. It is a dramatic situation,” said Helen Pope, a physician in Louisiana and assistant professor of medicine at Tulane University, in a statement to Senate staffers. “[T]hey are humans who are doing their best. Please don’t allow them to suffer more.”

Republicans hit a snag on Thursday after the Senate parliamentarian ruled that a proposal to change how states can tax Medicaid providers — a bid to pass on more costs to states — does not adhere to the rules for fast-tracking and passing legislation with a simple majority. Democrats hailed the decision as a win, but Republicans are still determined to make the desired cuts.

Experts say the cuts would drive up health care costs for everyone as providers are forced to raise prices and more people delay needed care until their conditions become catastrophic. Combined with the expiration of tax credits for Affordable Care Act (ACA) Marketplace insurance plans, which are not extended in the bill, the cuts would cause 16 million people to lose health coverage and lead to tens of thousands of preventable deaths each year.

Sharon Parrot, president of the Center for Budget and Policy Priorities, said the GOP’s failure to include the tax credit for people who rely on ACA Marketplace plans for insurance coverage is a clear indicator of Republican priorities. Lawmakers proposed the deep cuts to safety net programs in order to extend tax cuts for the wealthy passed during Trump’s first term while also increasing spending on the military and immigration policing.

“In the context of a bill that extends nearly all tax cuts from the 2017 bill, the one tax cut they have decided not to extend is the one that helps lower- and middle-income people afford health coverage,” Parrot said in a press conference on Wednesday.

Sen. Bernie Sanders (I-Vermont), the ranking member of the Senate Health, Labor, Education and Pensions (HELP) Committee, collected statements on the impacts of the budget bill from Pope and dozens of other doctors and health care providers across the country over the past month. Sanders released the statements on Wednesday along with a report detailing a massive increase in the number of people losing health insurance under the bill across all 50 states. In several states, the uninsured rates would nearly double or more over the next 10 years, including in Florida, Hawaii, Louisiana, Massachusetts, New York, and Washington, according to the analysis of Kaiser Family Foundation data.

“Plainly said, children will die as a result of these cuts,” said Farhan Malik, a pediatric special care specialist in Florida. “Doctors will leave because of salary cuts, critical ancillary services will be reduced, more medical students will avoid going into pediatric residencies.”

Earlier this month, Sanders and every Democrat on the Senate HELP committee sent a letter to committee chairman Sen. Bill Cassidy requesting a hearing on the bill with patients and health care providers. Cassidy, a Republican and physician from Louisiana, who has questioned Health Secretary Robert F. Kennedy Jr.’s anti-vaccine agenda in the past, declined to hold a hearing as Republicans debate cuts that data shows would harm people in their own districts. A spokesman for Senator Cassidy’s office referred questions to the majority staff on the HELP Committee, which did respond to a request for comment.

Cassidy’s home state of Louisiana would see the percentage of residents without health insurance nearly double to 12.4 percent by 2034 under the bill, a 91 percent increase over the 2023 uninsured rate. In a statement to the HELP Committee, the Louisiana Rural Health Association said the state’s rural hospitals and health providers are already operating on “razor-thin margins” and struggling to keep their doors open while serving some of the nation’s most medically vulnerable communities.

“In Louisiana, 38 percent of hospitals operate on negative margins, and 27 percent are currently vulnerable to closure,” the group said in a statement to the HELP Committee. “Medicaid cuts would worsen these losses, putting more hospitals at risk of shutting down entirely.”

The list of medical associations, disability rights organizations, and public health groups lining up against the bill is growing by the day. On Monday, the health care consumer group Families USA released a report estimating that 380 independent rural hospitals would be at risk of closure if Trump signed the reconciliation bill into law. Nearly half of all children and one in five adults living in rural areas rely on Medicaid, according to the National Rural Health Association. On Wednesday, 60 protesters were arrested for demonstrating against the cuts at the Senate rotunda in an act of civil disobedience, including disability activists in wheelchairs.

“We won’t stop protesting against this terrible bill, because it means our lives,” said Brandon Ezekiel, an activist with the disability rights group ADAPT, in a statement. “Our tax dollars pay for healthcare for members of Congress, many of whom are very wealthy, even millionaires, and then they have the nerve to cut our tax dollars from paying for health care for us.”

In a detailed letter to Senate leaders this week, the American Medical Association (AMA) warned that cuts to Medicaid and the Children’s Health Insurance Program risk “worsening access” to health care that many people already struggle to afford — and physicians must provide, whether or not patients pay the bills.

“Patients across the country are already struggling to access care,” said AMA President Bobby Mukkamala in a statement. “Physician burnout, early retirements and — with the cost of running a practice constantly rising — the challenge of keeping a practice financially afloat are contributing to a physician shortage expected to reach 86,000 by 2036.”

The pushback from the medical community appears to be having an impact. Sen. Josh Hawley (R-Missouri), Sen. Susan Collins (R-Maine), and other Republicans from states that rely heavily on Medicaid are warning their colleagues about the potential political fallout of pushing health care costs back onto states that already struggle to balance budgets. Politico reported on Wednesday that GOP leaders are offering their colleagues concerned about the cuts — whom they refer to as “Medicaid moderates” — a $15 billion “stabilization fund” for rural hospitals.

However, the fund is no substitute for robust Medicaid funding that many providers rely on, and would not prevent the budget bill from blowing huge holes in the safety net, according to Traci Gleason, communications director at the Missouri Budget Project.

“These cuts will pull the rug out from under Missouri families trying to make ends meet,” Gleason told reporters on Wednesday.

In order to meet the onerous work requirements Republicans are seeking to impose on Medicaid patients — requirements designed to reduce enrollment and further cut costs — Gleason said Missourians would have to file “piles of paperwork” with a state bureaucracy that is already overwhelmed.

“You simply cannot take billions of dollars out of Medicaid without causing massive coverage losses and taking away health care from people who are working and who are exempt” from work requirements, Gleason said, adding that 43 percent of rural clinics in the state are at risk of closing due to funding shortfalls. “Our system is already strained and will not be able to keep up, which means that every single person who has or will eventually need health coverage will be affected.”

Polls show GOP proposals to slash health care spending are deeply unpopular among voters, which may explain why Trump and his allies are attempting to pass the bill as quickly as possible. Sanders and Democrats have slammed Republicans for failing to hold hearings on the reconciliation package, and the Congressional Budget Office has not completed its standard analysis of the bill’s impacts.

However, it’s no secret that lower- and middle-income Americans are poised to lose the most under the GOP’s proposals, which would drain money from families already struggling due to the affordability crisis in order to pay for tax cuts that primarily benefit the wealthy. Analysis by the Yale Budget Lab found that the House version of the bill would reduce average incomes for the bottom 80 percent of earners when the impacts of Trump’s tariffs are factored in. The bottom ten percent of earners would see their incomes drop by 6.5 percent, while the top 10 percent would see a 1.5 percent increase.

Whether Senate Republicans can find enough votes to pass the budget package ahead of the self-imposed July 4 deadline remains to be seen. While some Republicans are wary of setting off a health care funding crisis at home, others point out that the bill would still increase federal deficit, despite the massive safety net cuts, by shifting federal funding toward Trump’s priorities, including billions of additional dollars for immigration enforcement.

Meanwhile, doctors and experts are making their position known, loud and clear.

“These harmful proposals will impact access to all patients who are served by our nation’s hospitals and health systems,” said Rick Pollack, president and CEO of the American Hospital Association, in a statement to the HELP Committee. “These cuts will strain emergency departments as they become the family doctor to millions of newly uninsured people.”