Your Voice is Needed: Protect Medicare, Medicaid, ACA, and SNAP

A Message from Kim Phelan, CEO, The Coalition for Hemophilia B and Coalition Member of BD SUMHAC

Dear Community Members,

No matter our differences, in politics, background, or beliefs, our hearts unite around one common goal: we care for one another. We all want our families, neighbors, and communities to be healthy, safe, and supported. That is what real strength and patriotism look like.

Right now, that shared strength is needed more than ever.

Congress is considering devastating cuts to Medicare, Medicaid, the Affordable Care Act (ACA), and SNAP, programs that millions of Americans rely on for healthcare, nutrition, and basic stability. These aren’t luxuries. They’re lifelines.

With a Senate vote expected before July 4 — a day that symbolizes liberty, justice, and shared responsibility, we must ask ourselves: Can we truly honor those values if we take away the very supports that uphold them?

Let’s also correct a harmful myth: These cuts do not just affect undocumented immigrants. In truth, the vast majority of people who rely on these programs are American citizens — seniors, children, people with disabilities, veterans, and working families. They are our relatives, our friends, our coworkers, and possibly even you.

Even if these cuts don’t affect you right now, they could impact your aging parents, your own future care, or your children’s access to basic needs. These programs exist to protect all of us, across every walk of life.

What’s often missing from the conversation is this: When people lose access to preventive and ongoing care, they still end up at the hospital, usually in the emergency room, the most expensive point of care. By law, they must be treated, and taxpayers are left footing a much higher bill. In the end, we all pay more, not less.

It also overlooks another critical truth:

When we reduce access to care, we don’t just harm individuals — we endanger public health. Large populations without healthcare can become breeding grounds for communicable diseases, putting entire communities, including those with insurance, at greater risk.

Some lawmakers claim these cuts are needed to prevent fraud. But the truth is, fraud in these programs is rare, and when it does happen, it’s most often committed by providers, not by the people who rely on them. These programs are already tightly monitored, efficient, and absolutely necessary.

This isn’t about partisanship. It’s about people.

Cutting healthcare and nutrition programs isn’t fiscal responsibility — it’s a moral mistake.

That’s why we’re asking you to take two minutes today to call your senators and say:

“Protect Medicare, Medicaid, the ACA, and SNAP. These aren’t wasteful — they’re essential. Families like mine depend on them. Let’s cut true waste, not care.”

Your voice matters. In unity, we can make a difference.

Call: 202-224-3121 or 866-426-2631

We have less than 30 days until the vote. Let’s make them count.

 Please see the links provided below to learn more about:

• The specific programs at risk

• How this bill would actually raise the deficit—not lower it

• Smarter, more compassionate alternatives that protect our communities without dismantling their lifelines

In unity, we say: we care. We show up. We stand together. Because when we care for each other, we build a stronger, safer, and more compassionate America.

With respect, compassion, and shared purpose,

Kim Phelan

CEO, The Coalition for Hemophilia B

download the advocacy action sheet

How this Bill will Raise the Deficit 

Bill Deficit and Tax Provisions

Key Financial Estimates:

• Tax Revenue Reduction: The bill’s tax provisions, including extensions of the 2017 Tax Cuts and Jobs Act, are projected to REDUCE federal revenue by approximately $4.6 trillion over 10 years.  
• Increased Spending: Additional expenditures on defense, homeland security, and immigration enforcement are estimated to add over $300 billion to the deficit.
• Spending Cuts: The bill proposes spending reductions totaling about $1.6 trillion, primarily affecting programs like Medicaid and SNAP.  
• Net Deficit Impact: Combining these factors, the bill is projected to increase the federal deficit by approximately $3.3 trillion over a decade.

Independent analyses, including those from the Penn Wharton Budget Model and the Committee for a Responsible Federal Budget, indicate that the bill would substantially increase the deficit. While the bill includes significant spending cuts, these are outweighed by the proposed tax reductions and increased spending in other areas, leading to a projected net increase in the federal deficit over the next decade.

Smarter More Compassionate Budget Solutions

Pentagon Waste & Contractor Over-billing

Estimated savings: $125–$200 billion annually

The Pentagon has never passed a full audit. Significant waste stems from overbudget weapons systems, contractor fraud, and inefficient spending.

Corporate Tax Loopholes & Offshore Evasion

Estimated savings: $150–$200 billion annually

Closing loopholes and taxing profits sheltered offshore could generate major revenue without raising rates on working families.

Fossil Fuel & Agribusiness Subsidies

Estimated savings: $20–$30 billion annually

These industries are highly profitable and don’t need federal handouts. Redirecting these funds would reduce pollution and promote sustainability.

Consolidating Duplicative Federal Programs

Estimated savings: $10–$25 billion annually

GAO reports regularly identify overlapping programs across agencies that could be merged for efficiency.

Requiring Competitive Bidding for Government Contracts

Estimated savings: $50–$75 billion annually

Ending no-bid contracts and requiring transparency would cut inflated costs and favoritism.

Total Potential Savings:Approximately $355–$530 billion per year without cutting Medicaid, Medicare, or the Affordable Care Act or SNAP 

THE SPECIFIC PROGRAMS AT RISK 

MEDICARE 

The $500 billion cut to Medicare isn’t a direct slash to patients, it’s the result of automatic reductionsrequired by the Statutory Pay-As-You-Go (PAYGO) law. This law is triggered when legislation increases the federal deficit without offsetting the cost.

Because the current budget bill would add more than $2 trillion to the deficit, PAYGO kicks in and Medicare is one of the few large programs legally subject to automatic cuts.

How It Hurts the Average American:

1. Reduced Access to Doctors

• Medicare pays less to doctors and hospitals.
• Fewer providers may be willing to accept Medicare patients.
• Seniors may face longer wait times or have to travel farther for care.

2. Strain on Rural and Underserved Areas

• Hospitals in rural or low-income areas, already under financial stress, may be forced to cut services or close altogether.
• Patients may lose access to nearby ERs, specialists, or surgeries.

3. Lower Quality of Care

• Reduced reimbursement means providers may have less time or fewer resources for each patient.
• This could especially affect people with complex conditions who need coordinated care.

4. Pressure on Medicare Advantage Plans

• Cuts could limit the scope or availability of Medicare Advantage benefits like dental, vision, or wellness programs.
• Premiums or out-of-pocket costs could rise for enrollees.

Who Gets Hurt Most:

• Seniors living on fixed incomes
• People in rural communities
• Those with chronic conditions who rely on frequent care
• Caregivers trying to help family members navigate the system

MEDICAID 

The new budget bill proposes $698 to $880 billion in cuts to Medicaid. These cuts would come through a combination of:

• Stricter work requirements
• Tighter eligibility checks
• Block grants or spending caps to states

How It Harms the Average American:

1. Millions Could Lose Coverage

• Up to 10 million people could lose Medicaid, especially adults in low-income jobs or those unable to meet new reporting requirements.
• Those most affected: working parents, people with disabilities, rural residents, and older adults not yet eligible for Medicare.

2. Work Requirements Are a Barrier, Not a Solution

• New rules would require people to work a set number of hours or report exemptionsregularly.
• But many Medicaid recipients already work in low-wage, unstable jobs (like food service or caregiving), where meeting or reporting hours is difficult.
• If they miss paperwork deadlines, they lose coverage, even if they qualify.

Yes, your understanding aligns with current data on Medicaid enrollees’ employment status. 

Most Medicaid Enrollees Are Working or Face Valid Barriers

According to a 2023 analysis by the Kaiser Family Foundation (KFF), approximately 64% of non-elderly adults on Medicaid are employed either full- or part-time. An additional 28% are not working due to legitimate reasons such as caregiving responsibilities, illness or disability, or attending school. This means that over 90% of Medicaid enrollees are either working or have valid exemptions from work requirements.   

Work Requirements Could Lead to Coverage Losses Without Increasing Employment

Implementing work requirements has historically led to significant coverage losses without a corresponding increase in employment. For instance, when Arkansas implemented such requirements in 2018, over 18,000 individuals lost Medicaid coverage, primarily due to challenges in meeting administrative reporting requirements, rather than a refusal to work.   

These findings suggest that while the majority of Medicaid recipients are already working or legitimately exempt, imposing work requirements could unjustly penalize vulnerable populations without achieving the intended policy goals. 

3. Coverage Gaps Lead to Bigger Problems

• Without Medicaid, people delay or skip care, which leads to:
• More ER visits (the most expensive care)
• Worsening chronic conditions
• Increased medical debt
• These burdens don’t go away, they fall on families, hospitals, and taxpayers.

4. State Systems Would Be Overloaded

• States would have to enforce the new requirements and absorb financial risk.
• This could lead to longer wait times, reduced services, or eligibility errors, especially in states already stretched thin.

Who Gets Hurt Most:

• Low-income working adults
• People with disabilities or chronic illnesses
• Single parents and caregivers
• Rural communities
• Children whose coverage depends on their parents’ eligibility

Affordable Care Act (ACA)

How Cutting ACA Funding Hurts the Average American

The proposed $100 billion cut to the Affordable Care Act (ACA) would slash subsidies that help over 13 million Americans afford health insurance through the marketplace.

What This Means:

• Premiums and Out-of-Pocket Costs Will Rise. Without subsidies, many individuals and families will see their monthly premiums and deductibles increase sharply, making insurance unaffordable.
• Up to 13 Million People Could Lose Coverage. The Congressional Budget Office (CBO) estimates these cuts could lead to 13 million more Americans becoming uninsured , not because they want to be, but because they simply can’t afford it.

Working-Class Families Are Hit Hardest and small business owners, part-time workers and people nearing retirement age but not yet eligible for Medicare would be most at risk.

• Economic Ripple Effects. As more people go uninsured, they delay care or rely on emergency rooms , driving up costs for hospitals, taxpayers, and insured patients alike.

SNAP

Cuts between $267 and $290 Billion  that would make it harder for people to access food:

• Stricter Work Requirements: Adults up to age 65 would be required to work or lose benefits.
• Limited Waivers: States couldn’t waive these rules even in areas with high unemployment, potentially affecting 6 million people.
• Administrative Burden: Recipients would have to submit quarterly proof of work, risking loss of benefits over paperwork delays.
• Reduced Benefit Calculations: The bill freezes the Thrifty Food Plan, meaning benefits won’t keep up with inflation making it harder to afford a healthy diet.
• Shifts Costs to States: States would have to pay 5% of benefits and 75% of administrative costs, which could lead to tighter eligibility and reduced help.

These changes will increase hunger, harm families, and strain local resources.

Why Is SNAP Already Hard to Get?

SNAP (Supplemental Nutrition Assistance Program) already has:

• Strict income and asset limits
• Detailed documentation requirements
• Time limits for “able-bodied adults without dependents” (ABAWDs) if they aren’t working a certain number of hours
• Complex rules around who qualifies, especially for students, immigrants, and low-wage workers

Many eligible people don’t even apply because the process is confusing, time-consuming, or stigmatizing.

So Why Are Some Lawmakers Trying to Make It Harder?

Recent proposals, like those in the House-passed bill would:

• Raise the work requirement age from 49 to 65
• Tighten exemptions for people with health conditions or caregiving responsibilities
• Add more red tape that could result in people losing benefits not because they’re ineligible, but because of paperwork or technicalities

Studies show that work requirements don’t increase employment, but do cause people to fall through the cracks and lose food assistance.

Who Gets Hurt?

• Low-wage workers with unpredictable hours
• Older adults struggling to re-enter the workforce
• Single parents who can’t find childcare
• College students trying to better their futures
• People with disabilities or mental health challenges who don’t always have documentation

SNAP is one of the most effective anti-poverty programs in the U.S., helping millions keep food on the table. Adding more barriers doesn’t reduce hunger, it just punishes people trying to survive.

We need to push for smart, compassionate policy that supports, not punishes, the people who need help the most.

Source: The Coalition for Hemophilia B