We all have a role in defending Medicaid against federal cuts. POCIL has gathered talking points to help you join the fight. You certainly don’t need to touch on all of these points, but think of this as a menu for what could be helpful, especially in speaking to a conservative lawmaker about Medicaid.

Cutting Medicaid Is Unpopular; Particularly to Pay for Tax Cuts for the Wealthy.

• Congress wants to slash Medicaid to pay for tax cuts for the powerful and wealthy. They’re on a mission to extend huge tax breaks for billionaires, big corporations and special interests, like oil and gas companies making record profits. Medicaid is not a piggy bank that Congress can raid to pay for tax cuts for the wealthy.

• Poll after poll shows voters do not support cuts to Medicaid. Medicaid insures nearly 80 million people in America and is as popular as Medicare and Social Security. More people support increasing Medicaid spending than cutting it!

Top Line Takeaways.

• Medicaid is a lifeline for coverage and a foundational source of economic and health security for 80 million Americans, and a key funding pillar for the doctors, clinics, and hospitals on which we all rely. 
• In Illinois, Medicaid covers 3.4 million Illinois residents including 1.5 million children (nearly half of the children in the state). 
• The Medicaid program is under threat this Congress. Congressional Republican leaders identified a number of potential policy proposals, all of which are cuts.
• The House cannot meet its $2 trillion in federal budget cuts without significant cuts to Medicaid. The nonpartisan Congressional Budget Office has confirmed this.
• Medicaid dollars are the largest source of federal funding to Illinois. Massive spending cuts will put an enormous strain on our state budget. 
• Medicaid operates as a state and federal partnership. Cuts at the federal level shift costs to the state.
• We will all pay the price for Medicaid cuts because of the far-reaching negative effects on the health care systems, state budgets, and our communities. 
• At a time of growing economic uncertainty, Medicaid cuts will make health care less affordable, sharply increase costs, medical debt, and financial insecurity for families, healthcare systems, and states. Congress should not make rushed, reckless cuts that will harm us.

Medicaid is Essential.

• Every community has someone who counts on Medicaid: children, new moms, older adults, and working people who don’t receive health insurance through their employer. Someone you care about is insured by Medicaid.
• Nationally, 5.6 million Americans count on Medicaid for their long-term care bills, including 6 in 10 nursing home residents.
• For older adults with low-incomes, Medicaid covers the gaps that Medicare does not fill. Every $3 of $10 Medicaid spending goes to Medicare enrollees. 
• Medicaid is the primary payor of mental health and substance use treatment services. 
• Rural and urban hospitals depend on Medicaid to provide in-patient care. 

Medicaid is Efficient and an Economic Driver.

• Illinois Medicaid is particularly efficient: Illinois is 44th in the nation for Medicaid spending per enrollee and Medicaid costs are well below those for private insurance. 
• Medicaid helps keep everyone’s healthcare costs down by reducing Illinois’ rate of uninsured individuals.
• Medicaid keeps rural hospitals and community health centers functioning, which not only supports patients but also provides jobs throughout Illinois.
• Medicaid helps people be healthy enough to work and provides job supports for many people with disabilities.

The Proposed Federal Cuts to Medicaid Are Reckless. 

• Congress is rushing through budget proposals that will require devastating cuts to Medicaid. The House Committee that oversees Medicaid has been instructed fo find at least $880 billion in spending cuts. There is no way for Congress to slash this much without drastic cuts. These cuts would strip health care from older adults in nursing homes, low-income children and parents, and people with disabilities, and leave states scrambling in the face of these cuts.
• $880 Billion is nearly a trillion dollars! $880 billion in Medicaid cuts translates to:
  • The cost of covering all 31 million children in Medicaid.
  • All federal Medicaid payments in 22 states.
• Federal cuts to Medicaid will not lower health care costs or improve quality and access to care–they will make our health care problems worse by sharply increasing costs, medical debt, and financial insecurity for families.
  
• Federal Medicaid cuts will ripple across our healthcare system. States will lose vital funding that covers health care services for American families, like doctor and specialist visits; mental health services; long-term care and nursing home care; and hospital care, particularly in rural areas. People’s health care needs won’t change; states will just have far less money to cover them.
  
• Illinois will not be able to come up with the money that is cut from the federal budget. People will lose coverage and Illinois’ bond rating will tank.
• Illinois will be forced to cut back on how many Illinoisans can enroll in Medicaid, will restrict services Medicaid can cover, and will slash provider rates, meaning fewer doctors will provide care to people covered by Medicaid.
• Cuts to federal funding will mean millions of families will lose their Medicaid coverage. Children won’t be able to get the preventive care they need to thrive, people won’t have access to pregnancy and postpartum care, and older adults will be unable to afford nursing homes and long-term care at home.
  
• A cut to Medicaid is a cut to Medicare. Medicaid pays premiums, co-pays, long-term care costs for millions of people who are enrolled in both Medicaid and Medicare, reducing out-of-pocket costs and allowing access to care and medication. These cuts will greatly harm older adults. For older adults with low-incomes, Medicaid covers the gaps that Medicare does not fill. Every $3 of $10 Medicaid spending goes to Medicare enrollees. 
• In the past five years, multiple hospitals in Illinois have closed their doors due to financial challenges. Medicaid cuts will force more hospitals to close.
• Every proposal Congress is considering to cut Medicaid will result in coverage losses. Currently, among the proposals are: ending provider taxes – which would slash the tax states can levy on providers to increase their Medicaid funding, and adding work reporting requirements – which would add paperwork obligations and bureaucratic hoops that states systems do not have the capacity to handle, which will cause health coverage loss even for people who are working.
• The massive spending cuts that Congress is proposing aren’t about getting rid of fraud, waste and abuse. That is a red herring. These rushed and reckless proposals will inevitably lead to steep funding losses for states that will be forced to cut benefits for seniors in nursing homes, low-income children and parents, pregnant women and people with disabilities.
• We need Congress to take Medicaid funding cuts – and all cuts to safety net programs and services – off the table and develop a careful, measured approach that balances fiscal responsibility with the health and well-being of millions of Americans. 

Thank you to our partners for compiling many of the materials from which we have drawn these talking points. These talking points last updated 3.12.2025