Republicans’ Medicaid cuts pit working Arizonans against the ultra wealthy

An Arizona nurse sounds the alarm about a new Republican budget proposal that will strip hundreds of billions of dollars from Medicaid while providing tax cuts for the wealthiest Americans.

Growing up in poverty in rural America, Elizabeth Lee was only able to see a pediatrician thanks to Medicaid, the public health insurance program that covers nearly 80 million low-income adults, people with disabilities, pregnant women, and children. 

“I remember our financial struggles quite clearly as a child and I distinctly remember feeling so grateful that we could at least see a doctor or a dentist when we needed to. Without that program [Medicaid], I would’ve gone without [healthcare] entirely because my parents just couldn’t afford it,” said Lee. 

Thirty years later, Lee works as a fertility nurse in Arizona, where many of her patients rely on Medicaid. They often use their coverage for birth control, prenatal care, postpartum care, and treatment for gynecologic conditions. 

Some of Lee’s patients could soon lose their coverage, however, under a bill being pushed by Republicans in Congress, which calls for hundreds of billions of dollars in cuts to Medicaid in order to pay for tax cuts that primarily benefit corporations and the very wealthy.

Lee believes the proposal could lead to the collapse of Arizona’s healthcare system and leave the vulnerable communities she treats without essential care.

“If we cut Medicaid, we cut people’s lives short. So we’ve got to reject any policy that treats healthcare as disposable. It’s a moral issue,” said Lee. “These proposed cuts would have catastrophic effects on access to the full spectrum of reproductive health services.”  

Medicaid funds about 46% of all births in Arizona and covers one in five women of reproductive age in the US. Medicaid can also help with preventative services, providing women with birth-control options to prevent unintended pregnancies. 

More than 2 million Arizonans rely on Medicaid, also known as AHCCCS in Arizona, for healthcare. But the proposal being pushed by Republicans in Congress could cause hundreds of thousands of them — including single mothers, veterans, and seniors — to lose coverage and access to crucial healthcare. 

US Republican Reps. Andy Biggs, Paul Gosar, and Eli Crane of Arizona are among those who back the effort to cut Medicaid. The legislation mandates that able-bodied adults who get Medicaid work, attend school, or volunteer for at least 80 hours per month to remain enrolled. 

But most Medicaid recipients already work. An analysis from the Center on Budget and Policy Priorities shows that 64% of adults with Medicaid worked full or part time in 2023, with 28% of adults on Medicaid not working because they were either ill or disabled, in school, or taking care of their home or family. Another 4% reported being retired, 2% reported being unable to find work, and another 2% fell under “other.” 

Although this measure wouldn’t be implemented until 2029 under the current bill text, advocates are worried that this new rule will only cause confusion and potentially cut people off from the program. In Arizona, a work requirement could be imposed even sooner at the state level. In accordance with a 2015 state law, AHCCCS is asking the federal government to allow it to implement a work requirement for able-bodied adults ages 19 to 55 and a five-year lifetime limit on Medicaid benefits for certain adults.

“Creating barriers for adults to maintain health coverage will only hurt families by threatening their health and making it hard for them to get jobs and stay working while increasing administrative burdens on the state,” wrote Jennifer Burns, director of government relations and health policy for the Phoenix-based Children’s Action Alliance.

Under the Republican proposal in Congress, Medicaid recipients must also complete two check-ins a year—an increase from the current process that only requires one annual check-in. In other words, if a recipient juggling work, family responsibilities, and a medical condition forgets to complete their check-ins, they are at risk of losing their coverage even if they’re eligible for it.

The Cost of Medicaid Cuts

Biggs, who is campaigning to be Arizona’s next governor, has repeatedly echoed Republican talking points arguing that the proposed cuts are aimed at rooting out “fraud,” despite studies showing that these cuts will disproportionately affect low-income individuals, children, seniors, and residents of rural communities.

Many rural hospitals depend on Medicaid funding. Without it, hospitals in rural communities like Yuma or Wickenburg might be forced to close their doors, and patients will have to travel miles to receive any type of care.

The Center for American Progress found that more than 200 rural hospitals across the country could be forced to shut down if the proposed budget is approved.

“Not only is this going to have devastating effects on people, but we are also going to see problems with everyday hospitals being able to operate. We’re already short staffed, so it’s really going to have catastrophic downstream effects,” Lee said. “We’re going to see a rise in overall health care costs and at the end of the day, it’s the constituents of these lawmakers that are truly going to suffer.”

Arizona’s Democratic representatives have vowed to put up a fight against the budget proposal and put political pressure on the GOP to preserve Medicaid.

“Republican cuts to Medicaid are reckless and will devastate Arizona’s healthcare system, economy, and the families who rely on the program for literal life-saving care,” said Rep. Yassamin Ansari in a joint statement with Senators Ruben Gallego and Mark Kelly, and Rep. Greg Stanton.

Kelly and Gallego have also been hosting town halls across Arizona to underscore the importance of saving Medicaid.

“Women in Arizona deserve to have control over their own bodies. But Republicans in Congress want to strip access to reproductive care from poor women in order to give tax cuts to the rich,” said Senator Gallego.

‘Let them truly feel the pushback’

The budget could still fail. Republicans in swing districts, including Arizona Reps. Juan Ciscomani and David Schweikert, are apprehensive about voting for the package given the potential political consequences of voting to cut healthcare for their own constituents.

Despite voting for the continuing resolution that paved the way for these massive cuts to Medicaid, Ciscomani later signed onto a letter to House Republican leadership encouraging them not to make cuts to Medicaid. 

Advocates like Lee are encouraging Arizonans to pick up the phone, pick up a pen, or write an email to your representatives demanding they protect Medicare. 

“People need to flood their lawmakers offices with physical mail, email, phone calls, voice mails. If you’re nervous, call after hours. Call truth to power. Let your lawmakers know specifically how this is going to impact you, your friends, your cousins, your sisters and let them truly feel the pushback from what this is going to do,” she said.