Proposed Government Cuts Will Jeopardize the Health of Millions

Author: Sylvia He, PhD

July 17, 2025

In April 2025, Republican members of the House of Representatives introduced the One Big Beautiful Bill Act, which includes significant federal budget cuts for the U.S. Department of Health and Human Services (HHS). This bill has passed in the House and will be voted upon in the Senate. HHS provides medical insurance to one in five Americans via Medicaid, the Children's Health Insurance Program (CHIP), and Medicare. If implemented, these cuts will destroy Medicaid and related programs, emaciating a healthcare system already devastated by Department of Government Efficiency (DOGE) cuts. In addition to these destructive cuts, Americans' access to accurate medical information is being restricted due to website removal, misinformation, and data deletion. Collectively, these actions will jeopardize the healthcare rights of more than 70 million children, the elderly, the poor, women, marginalized communities, and disadvantaged persons.

[Image source: telehealth.org]

The Importance of Medicaid

Disparity exists in healthcare for Americans. For example, high-income people tend to live longer, have better access to care, and are less likely to have chronic diseases. Underserved communities often have higher rates of chronic diseases and shorter life expectancy than Caucasian individuals. 

Several programs were created to address this disparity. The best-known and most successful is Medicaid, which federally funds healthcare for those facing financial hardships. It enables better access to care for 1 in 5, or 72 million, adults and children,  and almost 1 in 2 adults in poverty. With the expansion of the Affordable Care Act (ACA), Medicaid has further improved healthcare outcomes, such as earlier cancer diagnosis, lower cancer mortality rates, fewer cardiovascular and liver diseases, lower maternal mortality, and better diabetes, HIV, and addiction management, according to a collection of studies and their updates. Furthermore, Medicaid helps people become financially stable with less medical debt.

Medicaid is highly cost-efficient. It has lower total and per capita costs than Medicare and private health insurance. However, its reach and impact remain less known to the public because many states rename their Medicaid programs and run them through private insurance. 

The Proposed Budget Cuts

The One Big Beautiful Bill Act includes many cuts to HHS. For example, it proposes cutting Medicaid spending by more than 800 billion over next 10 years, or about 88 billion per year, more than 10% of the federal budget for Medicaid. It also includes  letting the subsidies expire for the ACA Medicaid expansion.

The federal government usually contributes around 70% of the budget for Medicaid. Thus, implementing a small portion of the proposed cuts will already have severe and wide-ranging negative effects on Medicaid enrollees and the U.S. healthcare system, according to the American Hospital Association. 

Budget Cuts Affect Everybody

Nearly 50 million Americans, about 1 in 7, have received health insurance coverage since 2014 through the ACA's Marketplaces and Medicaid expansion, as estimated by the U.S. Department of the Treasury. 

The Medicaid expansion is subsidized. The federal government helps states secure the costs of increased coverage to include previously ineligible low-income adults, to encourage the states to adopt the expansion. Letting the subsidies expire will deprive about 4 million individuals of their insurance, costing states $34 billion in gross domestic product and $2 billion in tax revenue. It could potentially bankrupt hospitals and providers due to the reduction in revenue. Furthermore, this will affect everybody with insurance. The Congressional Budget Office projects a 4.3% insurance premium increase for 2026 if the subsidies are not extended permanently. The expired subsidies could lead insurance premiums to rise by 7.7% in 2027 and by about 7.9% between 2026 and 2034.

Elderly and Disabled

While healthcare for the elderly is mainly covered by Medicare, Medicaid provides a crucial supplement to low-income elderly people. Medicaid covers 6.4 million elderly and 8.7 million disabled adults (1 in 4). These beneficiaries consume more than half of the Medicaid spending, so cuts to Medicaid will affect the elderly and disabled people the most.

The Medicaid cuts will compound the problems already caused by the Department of Government Efficiency (DOGE) cuts. DOGE has eliminated staff sanctioned to help seniors who are dually eligible for Medicare and Medicaid (i.e., seniors in poverty) apply for benefits. In addition, the program responsible for helping seniors get long-term care in their homes was also cut.

People of Color

People of Color generally have lower income, shorter life expectancy, more chronic diseases, and less access to health care than Caucasian individuals. Consequently, Medicaid covers a higher share of Black, Hispanic, and American Indian or Alaska Native individuals. Also, people of color are disproportionately affected by HIV. For instance, Black and Hispanic individuals make up 30% of the U.S. population, but accounted for 70% of the 31,800 new HIV cases in 2022. Lastly, Medicaid covers 2 in 5 of the 1.1 million adults with HIV. 

As Medicaid covers a higher share of marginalized individuals, these cuts will disproportionately impact communities of color, particularly patients with HIV. 

Children and Women

Significantly more children are poor than the national average. Consequently, Medicaid covers almost 4 in 10 children in general, over 8 in 10 children in poverty, and close to 1 in 2 children with special healthcare needs. In other words, 40 million children, almost as many as adults (47 million), are on Medicaid. Also, Medicaid covers 41% of all births, including nearly half of all rural births. Medicaid provides for 1.4 million pregnancies.

Money spent on children is money well spent. Federal programs that benefit children can have a 10-fold return on investment. In addition, Nobel Prize winner in Economics James Heckman and studies by the Urban Institute have found that children on Medicaid have improved health and mental health from childhood to adulthood. These children do better at school, are less likely to drop out of high school, and are more likely to finish college. Additionally, they have better prospects as adults. They are more likely to be employed and less likely to be in prison or need social services, providing a boost to the economy. Moreover, the Centers for Disease Control and Prevention (CDC) estimates that every $1 spent on childhood immunization, covered by Medicaid, results in savings of $11.

Medicaid cuts, as well as the removal of information that helps families access Medicaid benefits for children, will not only jeopardize the health of millions of children but also their mental health, academic performance, and prospects into adulthood.  

Single mothers are another group greatly benefiting from Medicaid. The poverty rate of single mothers is almost five times higher than married-couple households. Single-mother households do not make up the majority of American households, but they make up nearly half of the families living in poverty  3.3 out of 7 million. As a result, approximately 40% of single mothers rely on Medicaid. Medicaid cuts on the proposed scale will severely impact millions of single mothers as well as their children.

Veterans 

In general, American veterans are less healthy, with higher rates of chronic diseases (obesity, diabetes, heart disease, and chronic obstructive pulmonary disease) and mental health disorders (post-traumatic stress disorder [PTSD], depression, and addiction). 

Nine million veterans can access Veterans Health Administration (VA) healthcare. The VA has 482,000 federal workers and is short-staffed at 137 out of 139 locations. A cut of 83,000, as proposed by DOGE at the VA, will deteriorate the quality of care, especially when more veterans are enrolling (400,000 more in 2023 than in 2024). 

Psychological services will be hit the hardest. Veterans die by suicide much more often than civilians, with about 18 suicide deaths per day. VA's suicide hotline, with 800 to 900 counselors, fields 60,000 calls monthly. From 2009 and 2017, it made 3 million calls and 82,000 interventions for suicides and self-harm. Destaffing the hotline will cause tens of thousands of preventable deaths. 

Additionally, veterans rely on Medicaid; nearly 10% partially and 40% exclusively. Thus, Medicaid cuts will affect them. 

Vaccines

Vaccines are a large-scale, essential, life-saving preventive measure. 

Routine childhood vaccinations in the U.S. have prevented more than 1 million deaths. The COVID-19 vaccines reduced the death rate by more than half globally and by 75% in the U.S. Flu vaccination prevents thousands of deaths. 

Beginning October 1, 2023, adults and children covered by Medicaid and Children's Health Insurance Program (CHIP) will have guaranteed, free coverage of all vaccines recommended by the Advisory Committee on Immunization Practice (ACIP). Medicaid cuts will affect Medicaid users' access to vaccinations, particularly the elderly and the chronically ill, who are more likely to become sick and die because of the flu. 

In mid-June 2025, the entire panel of the ACIP was removed and replaced with vaccine skeptics. This has far-reaching implications. The ACIP develops recommendations on vaccine use, and these recommendations become official CDC policy once adopted by the CDC director. Thus, the new panel has the power to revise the recommendation on the use of currently available vaccines. If the new panel undoes the recommendations, the already-reduced access to free vaccines for people on Medicaid will be further reduced or canceled completely. Furthermore, the ACIP has the power to recommend, or not recommend vaccines. This covers the use of new vaccines for future outbreaks, such as the emergence of new COVID-19 variants and pandemics caused by new, unknown viruses. Without the ACIP panel to provide recommendations, the U.S.’s ability to deal with new outbreaks or pandemics will be immeasurably reduced, even if new vaccines are developed.

The Importance of Access to Health Information

In addition to reducing access to physical care, the government is making it harder for people to look up information to help themselves.

There is a digital divide in how different income groups access information. Low-income groups have always had less access than higher-income groups. The low-income group, with less broadband access, usually only searches using smartphones and accesses traditional media, such as TV and cable. Smartphone searches often prioritize sources that are faster, easier to load, and location-specific. This means people who are less financially secure do not see web pages that have larger files or images. In contrast, higher-income groups search using tablets and laptops. They can afford paid news subscriptions, books, and magazines.

[Image source: bluebraintech.com]

As a result, the information that the low-income group can obtain is less varied and in-depth. This directly affects how well they can access healthcare. For example, COVID-19 vaccination rates were significantly associated with household internet access in New York City. 

Because the low-income group has fewer digital resources, they rely on government agencies and/or their heads, such as the CDC, FDA, and HHS. These resources are free, essential, and authoritative distributors of health information. Every month, the CDC has 50 to 100 million website views and tens of thousands of downloads. 

Multiple children in West Texas were hospitalized for vitamin A toxicity from at-home attempts to treat measles. This treatment was advocated for by Robert F. Kennedy, Jr., the head of HHS. This is a perverse example of the importance of the government disseminating accurate information. 

Effect of limiting access to health information

Right now, there are substantial efforts to limit the general public's access to accurate health information.

In February 2025, thousands of government web pages were suddenly removed. The pages included medical guidelines or information on using contraceptives, testing for viral infections (such as HIV and COVID-19), vaccination, and mental health (parenting, post-partum depression, and addiction). 

While some websites were restored in the same month, many were not. Combined with staff layoffs on various educational programs, the removal of information can have detrimental effects on access to health information by less advantaged groups.

Women: Pregnancy and Contraceptives 

Specifically, the CDC publishes a broad range of guidelines to protect against various health conditions or risks, such as pregnancy and viral infections like HIV. These guidelines are go-to references for physicians, viewed hundreds of thousands of times and cited by thousands of scientific articles. 

Among the guidelines, the U.S. Medical Eligibility Criteria for Contraceptive Use (MEC) is of particular importance in helping low-income women, 21.4 million of them, access contraceptives.

Unwanted pregnancy is detrimental to the health and mental health of the mother as well as the child. Reducing unintended pregnancy will reduce the number unwanted pregnancies as well as improve women's academic achievement and health, increase their labor participation and economic contribution, and reduce crime rates among disadvantaged groups. 

However, there is a large divide between how people of different income levels can access contraceptives, which help reduce unwanted and unintended pregnancies. According to the latest report by the American College of Obstetricians and Gynecologists, 49% of pregnancies are unintended, and the probability of a poor woman having an unintended birth is more than five times higher than that of an affluent woman. 

In addition, there are more than 3.5 million births in the U.S. every year, 6% to 8% of which are high-risk. The U.S. has more pregnant women dying of childbirth than any other high-income country. 

The MEC, with detailed guidance for people with various medical conditions, from obesity, lupus, and kidney disease to HIV, is an essential and free resource for low-income and/or high-risk women and their doctors. It is frequently viewed and has had more than half a million reads during the past 12 months. However, the team responsible for producing and updating the MEC has been disbanded. Consequently, the health and lives of millions of women will be threatened.

HIV Testing

Approximately 1.2 million people in the U.S. have HIV, and more than 30,000 people become newly infected every year. 

Historically, the poor have been more likely to get infected by HIV, less likely to get tested, and more likely to die than the affluent. People of Color are also disproportionately affected by HIV. For example, in 2022, Black Americans accounted for 37% of new HIV infections, and Hispanics were 33%, even though they represent only 12% and 18% of the total population, respectively. Additionally, black gay and bisexual men (37%) and black women (52%) are disproportionately affected in their respective groups.

Currently, undiagnosed infection remains a major challenge in controlling the HIV epidemic. Late diagnosis delays prevention and is associated with poorer health outcomes and higher death rates. It also contributes to more cases. About 40% of ongoing HIV transmissions involve people who do not know they are infected. Insufficient testing also contributes to the delay in diagnosis. Black and Hispanic individuals make up most of the new cases because both populations remain considerably under-tested.

As Black and Hispanic individuals are twice as likely to be low-income as Caucasian individuals and more likely to be affected by HIV, free, accurate information from government websites provides a significant service to them. Removing these websites would disproportionately impact them more than more advantaged groups.

Inclusion of Minorities and Women in Clinical Trials

Until the 1990s, minorities and women were excluded from clinical trials because men were considered the 'dominant' gender, and Caucasian males were believed to constitute a 'normal' study population. 

Since then, extensive research has demonstrated that the physiological differences between genders and the subtle genetic variations between racial/ethnic groups significantly influence how effective a drug is for a given patient. Different doses are often needed for different groups of patients. Thus, it is considered essential to test a drug in as many different populations as possible.

Although the Public Health Act of 1993 was passed to include women and marginalized groups in clinical trials, they remain underrepresented. Removing information that supports greater inclusion of marginalized groups and women in clinical trials makes it more difficult to develop drugs that are safe and effective for everybody.

Restoration of health information

On February 11, 2025, a judge ordered the restoration of the federal health websites. While some data was restored, such as the Atlas Tool for tracking infectious diseases (e.g., HIV and sexually transmitted infections) and information on the Youth Risk Behavior Surveillance System, some websites remain down. 

Misinformation 

While government agencies are expected to be, and they usually are, sources of accurate information, the current head of the HHS, Robert F. Kennedy Jr., is involved in misinformation. 

Measles is one of the most contagious diseases a human can contract. One to three people who have the measles will die from neurologic or respiratory complications out of every 1,000 measles cases. But for less than $2 per child, measles vaccinations have saved about 60 million lives worldwide. 

However, Robert F. Kennedy Jr. is actively advocating for homeopathic ways of treating measles, such as with increased doses of vitamin A, a scientifically unproven method, instead of vaccination. Despite the deaths caused by measles in unvaccinated children, he insisted in a TV interview that treatment with steroids and cod liver oil was "getting very, very, good results."

Moreover, a fake CDC site called "realcdc.org," which looked almost identical to the real CDC website, was hosted by an anti-vaccine nonprofit once headed by Kennedy. The site was taken down at Kennedy's direction after the New York Times reported on it. It is nevertheless deeply disturbing how far the head of the U.S. Department of Health and Human Services (HHS) has gone to discredit the real CDC website, which has the highest medical and scientific credibility, and is maintained under HHS.

Stopping Data Collection 

There is no comprehensive federal regulation of the in vitro fertilization (IVF) industry. Some aspects of it are regulated by the FDA and the Fertility Clinic Success Rate and Certification Act of 1992. Meanwhile, regulation at the state level varies. A lack of industry regulation leaves consumers with little protection. 

Therefore, the data compiled by the federal government can act as a citizen protection plan. For example, past reports of the CDC team compiling IVF data pushed the medical community to adopt safer and more effective IVF methods. However, staff layoffs at HHS included the person compiling the most recent data on the IVF industry. In effect, protections for IVF patients, however little, have been taken away. 

The staff layoffs also affected the offices that collect data on sexual and domestic violence, pregnancy risk assessment, the prevalence of cancer amongst firefighters, the levels of lead in children's blood, alcohol-related deaths, asthma rates, and HIV transmission rates, to name a few. 

The halt in data collection and its effect on medical surveillance is deeply concerning and carries far-reaching consequences. Even Jerome Adams, the former Surgeon General under Trump, expressed concern: "Surveillance capabilities are crucial for identifying emerging health issues, directing resources efficiently, and evaluating the effectiveness of existing policies…Without robust data and surveillance systems, we cannot accurately assess whether we are truly making America healthier."

Conclusion 

Healthcare needs to be continually administered. It is not a faucet that can be turned on or off at will. Drastic Medicaid cuts and the allowance of ACA Medicaid expansions to expire will unleash unimaginable damage to the health and lives of tens of millions of Americans. Once the harm is done, it cannot be undone easily.

A democratically elected government is responsible for acting in the welfare of its constituents, particularly the weak, the old, and the less fortunate. Government agencies should be responsible for disseminating accurate information. The fact that the current administration is actively fighting efforts to better the welfare of its constituents is outrageous. Taxpayer money being used to fund the removal of health service web pages is deeply disturbing. This data collection needs to be restored and made available to all members of the public.

Healthcare is an essential right, and knowledge is what enables us to know what to fight for. Right now, the fight is on as both are under threat. 

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Glossary

• CDC: Centers for Disease Control and Prevention. The CDC protects Americans from health threats, including chronic or acute diseases that start in the U.S. or abroad 

• Chronic disease: conditions that last one year or more and require ongoing medical attention or limited activities, or both

• COPD: chronic obstructive pulmonary disease, a chronic lung disease that makes it difficult to breathe

• FDA: U.S. Food and Drug Administration, a federal agency of the U.S. Department of Health and Human Services responsible for protecting public health by ensuring the safety, efficacy, and security of food, drugs, medical devices, cosmetics, and radiation-emitting products

• HHS: The United States Department of Health and Human Services, a department created to protect the health of Americans and provide essential human services

• Immunization: The process of becoming resistant to a disease, typically through vaccination, or the administration of a vaccine

• Life expectancy: The average period that a person may expect to live

• Medicaid: A federal health insurance program in the U.S. for financially challenged people

• Medicare: A federal health insurance program in the U.S. for people aged 65 or older and younger people with disabilities

• Post-partum depression: A serious mental health condition that can occur after childbirth. It is more intense and long-lasting than the temporary “baby blues” that many new mothers experience.

• PTSD: post-traumatic stress disorder (PTSD), a mental health condition that can develop after experiencing or witnessing a traumatic event

• VA: The United States Department of Veterans Affairs, a department charged with providing lifelong healthcare services to eligible military veterans

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