Dear [firstname],
Since President Trump announced his budget proposal, which makes deep cuts to SNAP, Medicaid, and other vital federal programs, my office has received more than 13,000 calls about it. For context, my office received about 10,000 calls across all issues from January to June last year. People from all corners of Chester and Berks counties have reached out expressing their concerns about this monumental shift of resources from the poorest to the wealthiest Americans. They have been sharing personal stories about the impact these cuts would have on them and those they care about, and more than any other program, what they are talking about is Medicaid.
In our community alone, more than 141,000 of our friends and neighbors rely on Medicaid, including over 69,500 children and 15,000 seniors. So, I think it’s important to break down the Republican budget’s impact on healthcare.
TOPLINE According to the nonpartisan Congressional Budget Office, the Republican budget cuts to Medicaid will cause nearly 14 million Americans to lose their healthcare. Analysts at the Johns Hopkins Bloomberg School of Public Health predict this reduction in insurance will cause hospitals across the country to close and critical health care services to disappear, and that people will die as a result. |
Now into the details – Starting with some background:
WHAT IS RECONCILIATION? Reconciliation is a special budget process allowing for expedited debate and passage of critical fiscal legislation covering taxes (revenue), spending (the budget), or the debt limit (paying our bills). Reconciliation bills cannot be stalled by a filibuster and need only a simple majority, 51 instead of 60 votes, to pass in the Senate. As a general rule, it is most often used when one party has control of the House, Senate, and Presidency because it allows the majority party to push through a bill without input from the minority party. Republicans and Democrats have both used reconciliation to pass their agendas, including President Trump’s Tax Cuts and Jobs Act in 2017 and President Biden’s Inflation Reduction Act in 2022.
WHY NOW? Republican leadership in Congress is using reconciliation as a way to reauthorize President Trump’s Tax Cuts and Jobs Act (TCJA), which is set to expire at the end of this year. The TCJA cut taxes for the wealthiest Americans and largest corporations, shifting the costs to everyday Americans. President Trump has been pushing Speaker of the House Mike Johnson and Senate Majority Leader John Thune to get this bill passed and on his desk for signature by July 4. When the House voted on this bill on May 22, every single House Democrat, including the most conservative Democrats who represent districts won by Donald Trump in 2024, voted against it. |
HOW DOES THIS RELATE TO THE BUDGET? Reconciliation is a two-stage process that starts first with passing a budget resolution which instructs each committee to increase or decrease spending by a certain amount. In this case, President Trump asked Congress for $2 trillion in spending cuts over ten years. The bill that passed the House cuts spending by $1.3 trillion over ten years while cutting revenues (taxes) by $3.7 trillion. If you care about the federal deficit, this bill increases it by $2.4 trillion. Again, every single Democrat, including the most conservative ones representing districts won by Donald Trump in 2024, voted against this bill. Republicans in Congress “found” the money to pay for these tax cuts by massively cutting government spending elsewhere – namely social safety net programs like Medicaid, as well as the Pell Grant program for low-income students, tax credits for EVs and other clean energy programs, and SNAP which provides food for low-income Americans among other things. This bill also requires anyone applying for asylum to pay a new $1,000 fee and radically overhauls how low-income families get health care.
HOW WILL THIS IMPACT YOU (even if you’re not on Medicaid)? Cutting nearly $1 trillion from Medicaid and stripping health care coverage from nearly 14 million people will dramatically change the health care landscape in our country. Hospitals, doctors’ offices, nursing homes, long-term care facilities, physical therapy practices, and more rely significantly on Medicaid payments. Many of these facilities, especially in rural areas, won’t be able to survive such a dramatic decrease in revenue. Some could reduce their services or cut staff, others would be forced to close. This decreases the quality of health care for everyone in that area, not just those on Medicaid. We know firsthand in Southern Chester County how difficult it is not to have a hospital nearby after both Brandywine and Jennersville hospitals closed. This budget will only make getting care more difficult.
Additionally, without health insurance, many individuals and families might not be able to afford medical care. Families across the country will have to make difficult decisions about going to the doctor or putting food on the table. Some will opt not to get care at all, and some will die as a result. Others will rely on emergency rooms, increasing wait times at a decreasing number of hospitals, and exacerbating limited funds that could lead to more hospital closures, or increase medical costs for privately insured patients and raise taxes. Those without insurance often struggle to pay medical bills, meaning hospitals will need to take on more costs that could be unsustainable in the long term, leading them to close. Before that happens though, hospitals will likely look for ways to offset these new expenses, which could mean higher health care costs and insurance premiums for those with private insurance. State governments also, which receive millions of dollars in Medicaid, will be looking for ways to offset this loss of funding and could increase taxes in order to do so. |
Closing hospitals and other medical care facilities will also mean laying off the doctors, nurses, janitorial staff, and administrators at those facilities, as well as hundreds of others whose business is intertwined with the health care supply chain. Additionally, if more families are paying more for health care costs, they’ll have less to spend elsewhere, impacting our overall economy.
The Republican budget makes life harder and more expensive for everyday Americans, plain and simple. The worst part about these cuts, though, is not how disastrous they will be for the majority of Americans – which they will be – but the fact that these cuts will finance a $300,000 tax break for the wealthiest 0.1% –about 131,000 households – and $2 trillion in giveaways to CEOs and big corporations. The Center for American Progress reported that if this bill were to be signed into law, it “would be the biggest transfer of wealth from the poor to the rich in a single law in U.S. history.”
What can we do about it? Democrats in the House of Representatives have been pushing back on these disastrous cuts with every tool at our disposal. We’ve spoken about these cuts in hearings, in speeches, on social media, and in our communities. We’ve had conversations with our colleagues across the aisle, we’ve offered amendments to make the bill better, and we’ve sent letters to Speaker Johnson expressing our concerns about the cuts to vital programs like Medicaid. Republicans did not listen, and every single House Democrat voted against both the budget draft and the final bill. Since this bill is now in the hands of the Senate, I urge you to call Senator Fetterman and Senator McCormick to share your thoughts. |
Serving as our community’s representative in Congress is the honor and privilege of my lifetime and I hope you will reach out about the issues you care about.
As always, please contact my office if you need assistance. |
Chrissy Houlahan U.S. Member of Congress
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