As a pediatrician and public health advocate, I’ve spent my career serving families whose lives often depend on a strong safety net. Medicaid is that safety net. It provides care for over 70 million Americans — including children, pregnant women, seniors, and people with disabilities.
Right now, federal policymakers are considering dramatic Medicaid cuts that would threaten coverage for millions. This is not just a policy debate. It will spark a crisis that could destabilize our entire health care system. Even if you don’t treat Medicaid patients directly, these cuts will impact your practice, your hospital, and your patients.
1. Medical practices will struggle to survive. Medicaid is responsible for one in five health care dollars spent in the U.S. Cutting that support doesn’t just affect low-income patients — it threatens the viability of practices that serve them. Community clinics, rural hospitals, and safety-net providers operate on thin margins. If funding disappears, so do jobs, services, and access points.
For those of us in private practice, the ripple effects are real: more patients show up uninsured, uncompensated care rises, and everyone’s resources are stretched thinner. This is not theory — we’ve seen it happen in states that reversed Medicaid expansion, with billions in health care spending lost and clinics forced to close their doors.
Recently, I have been thinking about a patient whose experience really resonates today. A young boy with severe asthma had visited the emergency room multiple times because his family couldn’t afford consistent care. Once enrolled in Medicaid, we were able to set up regular visits, control his condition, and keep him out of the hospital — and in school. Medicaid didn’t just change his health. It changed his future.
2. ERs will become the front line for preventable crises. Without Medicaid, patients will delay care until it’s too late. A child with asthma who no longer has a pediatrician will end up in the emergency room. A diabetic adult without coverage will face complications that require ICU admission.
ERs are already overwhelmed — and cuts to Medicaid will overburden staff, overcrowd hospitals, and delay urgent care for all patients, regardless of insurance status. We all depend on a functioning emergency care system. We can’t afford to let it break.
3. Public health will suffer – especially for kids. Medicaid funds preventive care, chronic disease management, vaccinations, maternal care, and mental health services. Its expansion under the ACA saved lives — decreasing mortality rates and improving maternal outcomes, especially for Black and Latina mothers.
Today, Medicaid covers 37 million children. Take that away, and we’ll see a rise in missed vaccinations, untreated mental health conditions, and preventable illnesses. We will all feel the consequences of a less healthy population.
Another patient I remember vividly is a young girl with multiple developmental delays. Her single mother was doing everything possible to give her the care she needs and deserves. Thanks to Medicaid, she had access to therapies that helped her begin to communicate and thrive in a classroom. These services didn’t just support her — they lifted up the whole family.
4. Health inequities will widen. Medicaid is one of the most effective tools we have to reduce racial and geographic disparities in care. More than 40 percent of all U.S. births are covered by Medicaid — including 65 percent of births to Black mothers and nearly 60 percent to Latina mothers.
Cutting Medicaid now would roll back decades of progress, especially in underserved communities. Rural areas would lose essential hospitals. Urban areas would see community clinics disappear.
5. No doctor is immune. You may not treat Medicaid patients, but you will feel the impact. Your local hospital may close a key service line. Your insured patients may face rising premiums due to cost-shifting. Your referrals may hit a wall because the specialists your patients need are no longer funded.
Our health care ecosystem is interconnected. Pull out the Medicaid pillar, and the entire system collapses.
This is our fight — and it’s urgent. Congress is currently debating these cuts. As physicians, we have a moral obligation to speak up. Join your professional organizations. The American Academy of Pediatrics, the American College of Physicians, and others are already mobilizing. Call your elected representatives. Share stories of how Medicaid has helped your patients. Amplify your voice through op-eds and public forums.
When we are united in our call to action, our impact is powerful.
Let’s protect the health of our communities, our patients, and our profession. The sense of urgency is clear and the time to act is now.
Ilan Shapiro is a pediatrician.
