In January, Jonathan Riviera faced a life-changing event when he had to amputate part of his leg. He lives in Florida, one of the ten states that have chosen not to expand Medicaid under the Affordable Care Act. This decision has left many low-income residents without necessary health coverage.
Now, with House Republicans considering substantial cuts to Medicaid—potentially reaching hundreds of billions of dollars—Jonathan and his wife, Dani, are in a precarious situation. Both are disabled and rely on Medicaid for essential care and medical equipment, including prosthetics. The threat of losing their coverage looms large, especially since they qualify mainly because of their son, who is autistic.
Jonathan knows firsthand the importance of Medicaid. In the past, he struggled without insurance, unable to afford diabetes medication. This led to serious complications, including a painful condition called Charcot foot. After surgery to repair his foot, he returned to work as a cook, but the strain took its toll, leading to his amputation.
“Getting kicked off it,” Jonathan expressed, “would probably destroy me.”
Experts warn that current plans to cut Medicaid resemble the attempts made during Trump’s first term. Around 70 million Americans are on Medicaid, including about half who are children. In Florida alone, around one million people are excluded from coverage due to the state’s refusal to expand Medicaid.
In the past, the Rivieras had private insurance but faced high costs. Now, they trust Medicaid to support their health needs, making them anxious about possible cuts. David Machledt, a health policy expert, explains that if states lower income thresholds for Medicaid, many people may lose coverage, drastically impacting their health.
Elon Musk and other Medicaid critics often highlight supposed waste and fraud within the system, but the reality is starkly different. Most working-age adults on Medicaid are employed, and many disabled people qualify based on income, making them vulnerable to losing their coverage.
In North Carolina, Harper Phillips recently qualified for Medicaid through the state’s expansion. This change has allowed Phillips, who has chronic health conditions, better access to specialists without the constant worry of high medical bills. Like many, Phillips fears losing this coverage.
Changes due to Medicaid expansion have been swiftly felt in states that adopted it, with improvements in health outcomes and reduced medical debt. In rural areas, cuts to Medicaid could force hospitals to close, jeopardizing local health care services. There are concerns about the impact on children with disabilities, who may lose access to crucial treatments.
Some politicians propose work requirements to lower Medicaid enrollment, which could affect an estimated 36 million enrollees. States with such requirements create barriers that often result in individuals losing their coverage over paperwork issues rather than actual eligibility.
Implementation of work requirements comes with administrative challenges. Many people lose coverage simply because they cannot provide required documentation on time. According to experts, it’s unrealistic for states to cover the costs associated with federal Medicaid cuts on their own.
Jonathan, Dani, and countless others rely on Medicaid not just for their health but for their lives. Without these programs, their future is uncertain, highlighting the ongoing struggle for accessible healthcare in America.
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