My mother was at the doctor on Tuesday for her usual checkup. She’s been on Medicaid ever since Dad died, three years ago. She can’t afford regular insurance on just Social Security.
Dr. Martinez, who has been taking care of our family for 15 years, looked concerned when he entered our hospital room. Not about Mom’s health, but her insurance.
“There’s a little thing you should know about Medicaid cuts 2025,” he said. “Things are about to get complicated.”
What Actually Happened In July
Many people missed it since it happened over a holiday weekend (Fourth of July). When you were busy cooking out burgers and shooting off fireworks this week, President Trump signed something called the “One Big Beautiful Bill Act” into law.
Sounds harmless enough, right? Wrong. The bill includes a reduction in Medicaid spending by 15%, which may not sound like very much until you contemplate what that means for real families.
My mom’s jaw dropped when Dr. Martinez explained it. “Fifteen percent of what?” she asked.
“Everything,” he said.
The Numbers That Keep Me Up At Night
The Congressional Budget Office found that the OBBBA would reduce federal spending on Medicaid and Children’s Health Insurance Program (CHIP) benefits by $1.02 trillion. That’s trillion with a T.
It would strip at least 10.5 million people from the programs by 2034. 10 million people no longer have health insurance. In America. In 2025. I attempted to explain this to my brother over dinner last weekend. He does well, has company insurance, and doesn’t think much about Medicaid.
“Ten million people?” he said. “It’s like the entire state of Michigan losing their coverage.”
Exactly.
Who Gets Hit Hardest
Now, that’s what really gets me going. For more than 7 million older adults and 12 million people with Medicare, Medicaid is a lifeline. We are talking about people like my mom. Folks who have worked all their lives, paid their taxes, and now need help.
The Medicaid cuts 2025 are not just about poor people, though politicians like to put it that way. My neighbor Steve is on disability after a work accident. His wife is apparently employed part-time by Target. Combined, they earn too much to qualify for food stamps but too little to afford private insurance.
Medicaid pays for Steve’s physical therapy, his medication, and his doctor visits. Without it, they’re screwed.
The Work Requirement Nobody Asked For
The new law also imposes work requirements. The 20-hour weekly work requirement is limited to able-bodied adults who do not have young children, the White House said.
The situation seems reasonable, except that it isn’t. My cousin Lisa has lupus. Some days she feels fine. Other days, she can hardly get out of bed. Is she “able-bodied”? Who decides?
The paperwork alone will be a nightmare. You have to prove you’re working twenty hours a week, every week. Miss the deadline? Lose your coverage.
My aunt works at the county social services office. She says they’re already overwhelmed. “We can’t handle the current workload,” she told me. “Adding more requirements just means more people falling through the cracks.”
Also read: What Nobody’s Telling You About Medicaid Cuts 2025
What Doctors Are Really Saying
Dr. Martinez is not the only physician with this concern. I phoned my family dentist, Dr. Johnson, who has been taking care of Medicaid patients for twenty years.
“Medicaid does not pay very much,” he said. “But it’s better than nothing. If 10 million people lose their coverage, where do they go? The emergency room? That’s a lot more expensive than the normal checkups.”
He’s got a point. When preventive care is unaffordable for enough people, they wait until things are very, very bad. And that results in their being in the ER with problems that might have been diagnosed early.
Who do you think pays for those ER visits? All of us, through higher insurance rates and hospital expenses.
States Are Freaking Out
And when federal funding for Medicaid falls, states typically trim optional benefits, including home- and community-based services, first. That’s fancy speak for cutting the cash that enables seniors to live in their homes or at least in communities of fellow seniors rather than in nursing homes.
My grandmother came to live with us during her final two years because we could not afford assisted-living care. It was hard on everybody, but particularly on Mom. If she could have had home health aides paid for by Medicaid, Grandma could have stayed in her place.
These cuts will precipitate families into impossible situations like ours.
The Real Cost Nobody Mentions
Here’s what I can’t stand about this whole business. The OBBBA will slash roughly $1 trillion in federal Medicaid spending between 2025 and 2034. Not only that, but it provides gargantuan tax cuts for wealthy individuals and corporations.
So we are taking health insurance away from poor people to give wealthy people a tax cut. I don’t think that’s right.
My brother-in-law is an accountant. He looks at tax returns all day. “The people who are receiving these economic tax breaks don’t need them,” he said. “They’re already doing fine.”
What Happens To Real People
Mom’s already making plans. She’s rationing her diabetes medication to make it last longer. Skipping some doctor appointments. Looking into what Medicare covers versus what Medicaid pays for.
She’s not alone. Every Medicaid patient in America is doing the same math right now.
“I worked forty years and paid into the system,” Mom said after her appointment. “Why am I being punished for getting old and needing help?”
Good question, Mom. I don’t have a good answer.
The Bottom Line For Families
If you’re on Medicaid, pay attention. The Medicaid cuts 2025 are real and they’re happening now. States are already planning how to reduce services.
If you’re not on Medicaid, this still affects you. When millions of people lose coverage, healthcare costs go up for everyone.
Dr. Martinez gave Mom his cell phone number. “Call me if you have problems,” he said. “We’ll figure something out.”
That’s America in 2025. Good doctors trying to help their patients while politicians play games with people’s lives.
Some things never change. The people who need help the most always seem to be the first ones to lose it.