Beyond the Budget: What Medicaid Cuts Mean for Real Families
The Myth of the “Safe” Medicaid Cut
Lawmakers often claim that Medicaid cuts won’t hurt the vulnerable. But there’s no such thing as a “safe” Medicaid cut—not when you’ve met families like Lisa’s.
After high school, Lisa took courses at a local community college, unsure of what she wanted as a career. However, at age 20, Lisa married her husband, Ben, and shortly after, found out she was pregnant. Lisa set school aside to prioritize her new family.
Lisa’s pregnancy was difficult. Midway through, she learned that her baby would likely be born with disabilities. With this news, Ben became more and more distant with Lisa, and shortly after Charlie was born, Ben permanently left his family.
As Lisa tried to make ends meet as the single parent to a child with profound disabilities, she received assistance from the government in the form of Medicaid and SNAP benefits. Charlie also received Medicaid benefits due to his cognitive and physical disabilities. This included physician visits, as well as Occupational, Physical, and Speech Therapy.
Lisa tried again and again to work outside the home. Each time, she felt the sting of shame, especially when others around her said things like, “There should be work requirements for Medicaid” or “People on Medicaid are lazy.”
Without a college degree, Lisa was unable to secure enough income while working outside the home to support herself and Charlie without relying on Medicaid benefits.
A decade later, Lisa learned about a local program that helped parents like her return to school. It wasn’t easy—juggling Charlie’s appointments, managing the house, and studying late into the night—but she earned her degree in dental hygiene. It didn’t fix everything. But for the first time in years, Lisa felt like she could breathe. Medicaid made that possible—just enough support to imagine a life with stability, and a little more dignity.
But in 2029, the cuts from the so-called “Big Beautiful Bill”—passed in 2025 by then-President Trump and a Republican-led Congress—finally began to hit home. That’s when everything started to unravel.
Now, Lisa is experiencing regular panic attacks. Due to the cuts, Charlie’s benefits have been significantly decreased. He no longer qualifies for OT, PT, or Speech Therapy services, and the hours for his aides have been decreased as well. Lisa has found herself having to take more and more time off from work due to reduced aide coverage for Charlie.
Today, Lisa received a phone call that her father, who is currently in a nursing home due to dementia, is no longer able to reside there. The nursing home is closing down due to lack of Medicaid funding. In fact, due to the cuts, there are no nursing homes available within 4 hours of Lisa’s home— and even those nursing homes are full.
Lisa doesn’t know what to do. If she doesn’t work outside the home, she won’t be able to financially support herself and Charlie. She’s considered taking her father in, but she knows he needs more care than she can safely provide.
Worst of all, the new work requirements mean that if Lisa quits her job to care for Charlie and her father, she’ll lose the very benefits she needs to keep them alive.
Lisa sits at her kitchen table, bills stacked beside her, her father confused in the next room, and Charlie humming softly from the couch. She stares at the Medicaid notice one more time. There’s no answer—just the cruel arithmetic of a country that decided her family was too expensive.
I’ve worked in healthcare for over a decade. I’ve met the Lisas. I’ve treated the Charlies. And I’ve seen firsthand what happens when we force families to choose between dignity and survival.
Lisa’s story isn’t unique—it’s just one of the countless stories we’ll never hear if we keep writing policy without listening.
This is the future we’re choosing. Lisa didn’t fail, but our policies did. Because we’ve decided that only some lives are worth supporting.
P.S. Some claim Medicaid cuts won’t affect people with disabilities. I plan to share a short follow-up this week unpacking that myth. If you have questions you'd like addressed, feel free to leave them in the comments.