Bob Casey: Republicans want to kick at least 8.6 million Americans off their health insurance

Abigail, Bridget, and Collin Gabriel. Cole Farrell. These are the names of some of the “Little Lobbyists” I had the privilege of meeting while serving Pennsylvania in the U.S. Senate. They are children with disabilities who have fought to save their healthcare, starting in 2017 during attempts to repeal the Affordable Care Act.

These Little Lobbyists are active today, as Republicans debate a dangerous and cruel proposal: kick millions of Americans off Medicaid to finance tax cuts for the wealthiest Americans and large corporations. The Little Lobbyists are among the most effective advocates with whom I’ve worked, but they are far from the only Americans who will be hurt by these draconian cuts to Medicaid.

There is an ill-conceived notion that Medicaid is a program only for the very poor among us. That is not true. Medicaid pays for 41% of all the births in the United States, and covers nearly 40% of all American children.

For kids with disabilities, that number is significantly higher, at 59%. Children with complex disabilities rely on Medicaid to pay for the extra care they need while being able to live in their own homes.

It’s a vital protection for tens of millions of Americans who never expected to need it — until they did.

As rural hospitals struggle financially, more and more are reliant on Medicaid reimbursements. Pennsylvania has 48 rural counties and 42 rural hospitals, along with scores of rural health facilities and clinics. When a farmer has a heart attack, the proximity to a local hospital rather than one two counties away may save his life.

Finally, Medicaid is helping combat the opioid epidemic ravaging communities across the nation. Medicaid provides comprehensive treatment options for people struggling with substance use disorders, and states that expanded Medicaid under the Affordable Care Act have seen significantly better outcomes in addressing this epidemic — including a decrease in overdose deaths.

These are not examples of generational poverty or chronic government dependency. Young parents can save for a child, but be forced to quit their jobs to care for a baby with a rare disease that requires round-the-clock care. A factory worker might be prescribed painkillers after an injury, and find themselves out of work, battling opioid use disorder, and in need of help. A senior in a rural community may visit their local hospital for care until one day it is no longer there. These are hardworking Americans who rely on Medicaid-funded healthcare in some of life’s toughest moments.

Why, then, would Republicans want to cut Medicaid? Republicans in Congress are debating a bill that will extend and expand on their 2017 tax giveaway for corporations and billionaires. Despite promises from Republicans, those tax cuts did not pay for themselves. Instead, they added nearly $2 trillion to our national debt.

Corporations did not reinvest that funding into their workers or communities; they used their windfall to buy back stocks and reward their shareholders on Wall Street.

Now, Republicans want to do it again. According to the Budget Lab at Yale, the proposals Republicans are currently considering would give people making over $646,000 an additional $43,000 in tax cuts, while forcing the lowest-income Americans to pay $1,125 more in taxes.

To pay for the obscene, wasteful benefits for the rich, they want to kick at least 8.6 million Americans off their health insurance.

This is a debate about priorities. Do we want to be a country where a family goes bankrupt because of a child’s unexpected disability? Where a family loses a loved one struggling with opioid use disorder because they can’t get the help they need? Where a man dies on the way to the hospital because he has to drive over an hour to get care?

I believe most Americans, regardless of political affiliation, would answer no to these questions. Medicaid tells us who we are as a nation. It’s a vital protection for tens of millions of Americans who never expected to need it — until they did. And, if we’re able to save it, Medicaid may also one day be there to help you and your family.

Bob Casey is a former United States senator from Pennsylvania, serving from 2007-2025. He was a senior member of the Senate Finance Committee, where he worked to protect and expand Medicaid. He resides in Scranton.