10 Arguments for Cutting Medicaid—and Why They Fall Apart
They say it's about work, fraud, and fiscal responsibility. But the truth? Real people lose care.
Last week, I shared Lisa and Charlie’s story—what happens when budget cuts aren’t just numbers, but real lives. I promised a follow-up to unpack the talking points behind the policy. This is that piece.
There’s a lot of noise right now—on social media, in comment threads, even from elected officials. These talking points show up everywhere. Let’s take a closer look.
1. “People need to work if they want benefits.”
✅ Reality:
Most Medicaid recipients already do work—or they care for loved ones, live with disabilities, or are in school. But here’s the catch: even with a job, many don’t earn enough to afford private insurance. In fact, nearly 3 in 5 adults on Medicaid are already working, often in low-wage jobs that don’t offer benefits. Work requirements don’t boost employment—they just add red tape. Miss a form, a deadline, or a shift, and you lose coverage. Not because you’re lazy, but because you’re navigating a system designed to trip you up.
2. “People just need to make better choices.”
✅ Reality:
No one chooses disability, cancer, a stroke, or a premature birth. And poverty isn’t a moral failure. It’s often the result of policy failure. The truth is, most Medicaid recipients are doing everything they can, but they’re forced to navigate a web of employment, healthcare, and bureaucratic hurdles that makes accessing care far harder than it should be.
Yes, some people make poor decisions. But poverty isn’t just the result of bad choices. It’s often the result of impossible ones, like choosing between rent and medication, between childcare and a job, between survival today and stability tomorrow.
Personal responsibility does matter. But even good choices aren’t always enough to overcome broken systems. And basic healthcare shouldn’t be reserved for those who never make a mistake. It should be guaranteed for everyone.
3. “Medicaid is full of fraud and waste.”
✅ Reality:
Medicaid actually has one of the lowest fraud rates of any federal program. Most of what’s labeled “waste” comes from red tape, not wrongdoing — complex rules and inefficiencies, not people trying to cheat the system.
Yes, there will always be some fraud in any large program. That’s human nature. But it’s not a reason to dismantle the system. We can demand accountability without using a few bad actors to justify cutting care for millions.
And here’s what often gets overlooked: Most Medicaid fraud doesn’t come from patients lying to get care. It comes from providers inflating bills, charging for services they never delivered, or exploiting the system for profit.
4. “We need to cut spending or we’ll go bankrupt.”
✅ Reality:
We’re not broke. We’re just making the wrong choices, like handing out huge tax breaks to billionaires while claiming we can’t afford basic care for kids with disabilities or low-income seniors.
The 2017 tax law added nearly $2 trillion to the deficit, mostly helping the wealthiest Americans. These cuts didn’t “pay for themselves.” They didn’t spark a wave of job creation or boost wages in any lasting way. What they did was drain funding from the programs that help everyday Americans.
Some massive companies, like Amazon and Netflix, have paid $0 in federal income taxes in recent years. Many of the wealthiest individuals use tax loopholes and offshore havens to avoid contributing their fair share, while teachers, nurses, and small business owners foot the bill.
That’s the real crisis—not Medicaid. Blaming people who rely on care instead of holding powerful corporations accountable isn’t fiscal responsibility. It’s a moral failure.
5. “If this bill hadn’t passed, taxes would have gone up.”
✅ Reality:
Taxes wouldn’t need to increase if we stopped giving billionaires and large corporations enormous tax breaks. This is a false choice: we could fund essential care and still close corporate loopholes.
6. “There are no cuts to Medicaid in the Big Beautiful Bill.”
✅ Reality:
On paper, the bill doesn’t directly slash Medicaid. But that’s not the full story. It reduces funding, tightens eligibility, and adds new restrictions. That means fewer people will qualify, and some services will quietly disappear.
It’s not a line item labeled “cut”—but the impact is the same: people lose care.
And why are these changes happening? To help offset the cost of even more tax breaks for the ultra-wealthy. So when leaders claim they’re “protecting” Medicaid, but the result is fewer covered families and shuttered programs, that’s not protection. That’s a cut—just with a different name.
7. “This won’t impact single parents, kids, or people with disabilities.”
✅ Reality:
It already is, thanks to changes at both the federal level under the Big Beautiful Bill and shifts in state programs. None of this is hypothetical.
What’s Changing Under the Big Beautiful Bill?
Work requirements & paperwork burdens are projected to remove healthcare from millions, including parents and adults with chronic illness. The CBO estimates 5 million adults could lose coverage by 2034—largely due to new reporting requirements and reduced eligibility.
Cuts in provider reimbursements and funding caps will strain nursing homes, rural hospitals, and home health services, threatening closures and jeopardizing care for children and adults who rely on them.
What’s Already Happening at the State Level
In Arkansas, a pilot Medicaid work-requirement program led to 18,000+ people losing coverage in just months—and it had no effect on employment rates.
The Urban Institute found that nearly all adults who lost Medicaid due to state work requirements either went bankrupt or became seriously ill as a result of losing coverage.
Meanwhile, 338 rural hospitals nationwide—including 11 in Ohio and 25 in Pennsylvania—are now on the brink of closure due to Medicaid cuts.
8. “Illegal immigrants are getting free healthcare while Americans suffer.”
✅ Reality:
Undocumented immigrants do not qualify for full Medicaid benefits. In emergencies, hospitals may provide care under federal law—but that’s about keeping people alive, not giving out perks.
What many people don’t realize is this: many undocumented immigrants pay taxes that fund programs they can’t even use. They contribute to the system without receiving the same support in return.
This claim isn’t just inaccurate—it’s a distraction. It turns neighbors into scapegoats and shifts attention away from real issues. When we blame the most vulnerable, we let those in power off the hook.
9. “Churches and charities should help—not the government.”
✅ Reality:
Churches and nonprofits do important work, but they can’t fund an entire nation’s healthcare needs. Especially when those needs include ICU care, ventilators, and long-term disability support. This is a government-scale issue.
10. “States should handle Medicaid—not the federal government.”
✅ Reality:
Medicaid is a shared effort for a reason. Many states—especially rural or lower-income ones—don’t have the resources to meet healthcare needs on their own. Without federal support, care would disappear for millions.
And in places where states have been given more control, we’ve seen what happens: work requirements, long delays, limited coverage, or outright refusal to expand access. Kicking the responsibility down the road doesn’t solve the problem—it just makes it easier to ignore.
Yes, we all know—or at least suspect—someone who may have taken advantage of Medicaid. And yes, that’s frustrating. But this isn’t an all-or-nothing game. A few misuses don’t justify cutting care for everyone else.
If you come from a faith tradition like I do, you might remember: Jesus didn’t avoid the poor. He didn’t shame them, test them, or ask for proof they were deserving. He fed them. He healed them. He stood with them. He never said, “cut their funding.” He said, “what you do for the least of these, you do for me.”
The people making these decisions—the ones crafting these talking points—aren’t some far-off elites. They’re our own elected representatives, sent to Washington to serve us. And yet, most of them have likely never scraped by month to month, wondering how to afford a doctor after finding a lump, or whether to pay the heating bill or buy food. They haven’t just lost empathy. Worse—they’ve become numb to other people’s suffering.
But we don’t have to be. Call your representatives. Write to them. Show up, speak out, and don’t let this issue slip quietly through the cracks.
The ten arguments above might sound like just talking points, but they have real consequences. They shape policy, steer funding, and determine who gets care, and who doesn’t.
We owe it to the millions who depend on Medicaid to tell the truth—and to keep telling it, especially when it’s uncomfortable.
Sources:
General Medicaid Context and Public Opinion
• What the Data Says About Medicaid — Pew Research Center (2021)
Work Requirements & Coverage Losses
• Impact of Arkansas’ Medicaid Work Requirements — Health Affairs
• Medicaid Work Requirements in Arkansas: 18,000 Lost Coverage with No Employment Gains — KFF
• State-by-State Estimates of Medicaid Expansion Coverage Losses — Urban Institute
Fraud, Abuse, and Program Integrity
• The Truth About Waste and Abuse in Medicaid — Center for Children and Families
• Medicaid Improper Payments Report — GAO
• Medicaid Fraud Myths — CBPP
Economic & Fiscal Impact
• Effects of the 2017 Tax Cuts and Jobs Act — CBO
• CBPP Analysis: Budget and Tax Tradeoffs
• Projected Health and Economic Impacts of Medicaid Cuts (2025) — JAMA Health Forum
Hospital Closures & State-Level Effects
• Rural Hospital Closures Tracker — UNC / North Carolina Rural Health Research Program
• 338 Rural Hospitals at Risk of Closure — Chartis Center for Rural Health
Immigrants and Medicaid
• Facts About Immigrants and Medicaid — KFF
• Immigrant Tax Contributions — CATO Institute
• Immigrants Contribute Billions in Taxes — American Immigration Council
Moral & Ethical Perspectives on Medicaid
• Why Medicaid is Essential — Georgetown Center for Children and Families
Eligibility Rollbacks & Federal Trends
• CBO Estimates of Medicaid Coverage Losses
• KFF Medicaid Unwinding Tracker — Kaiser Family Foundation