These physicians voted for a bill that is estimated to have 11.8 million Americans lose their largely federal government funded health insurance, Medicaid, over the next decade.

Medicaid currently covers 71 million individuals who must meet certain qualifications. Included are low-income families, qualified pregnant women and children, children in foster care, people with disabilities, seniors with low income, parents/caregivers with low income, and individuals receiving Supplemental Security Income (SSI). It also covers those with certain diagnoses such as end-stage renal disease on dialysis, HIV/AIDS, and cancer. There will also be cuts to the Health Insurance Marketplace program (under the Affordable Care Act best known as “Obamacare”) that serves 24 million Americans who work; many are pre-retires, part-time workers, independent contractors, and small business owners. Notably, both programs cover a large portion of rural America.

Many individuals on Medicaid work but are not provided with commercial health insurance by their employer and cannot afford it on their own.

Unlike the federal government (which will add $3.4 trillion to the federal debt due to this bill), state governments must balance their budgets. When less federal funding is provided for state-run Medicaid programs, the states must fill in the gap. If they cannot, covered services will decrease and people will be removed from the program to make ends meet.

Projections from the University of Pennsylvania, Harvard and Yale estimate that less funding for Medicaid could result in 51,000 lost lives per year. This can be due to several factors, including losing access to low-cost medications (like insulin), decreased quality standards for healthcare facilities, less funding for medical education, and delays in care.

Furthermore, we know that those without insurance are far less likely to seek timely medical care. Twenty percent of adults without insurance, in comparison to 5-7% with insurance, went without needed care because of the cost. The cost of healthcare can be financially debilitating as medical debt accounts for 66.5% of bankruptcies in America, with more than a half million people filing every year for this reason alone.

These cuts are proposed to decrease government spending by $1.1 trillion on Medicaid, Medicare and The Affordable Care Act (Obamacare) over the next decade. More than $1 trillion of the cuts are to come from Medicaid alone.

The very news of losing funding has already had its first casualty. Community Hospital (a healthcare system in McCook, Nebraska) announced July 2, 2025 that it will close Curtis Medical Center in Curtis.

How is it that the federal government is cutting funding, yet our debt is increasing? Show me your budget and I’ll show you your values. Our checkbook shows our treasures to be big business, border control and billionaires. Forty-six and a half billion is set to construct the border wall that Mexico was “supposed” to build. Another $45 billion is allocated to detention centers for immigrants in custody with an additional $30 billion to fund Immigration and Customs Enforcement (ICE) agents. Finally, the top 20% of income earners will receive a disproportionate amount of the extended and new tax savings.

The consolation prize is $50 million to support rural hospitals. This is a drop in the bucket as the cost to run even a small hospital is estimated to be in the 10s to 100s of millions of dollars a year. The closing of facilities will not only lead to increased death and morbidity for the people these centers serve, but also to economic disaster as the local hospital is often a major economic engine keeping these communities financially viable. The $50 million is too late to save Curtis Medical Center and will be too little to save others.

Left out completely is targeted funding to support urban healthcare centers, which carry the load of providing uncompensated care to a diverse population in our larger cities. These safety net facilities are also in jeopardy.

One recent example is the closing of two Atlanta, Georgia hospitals by WellStar Health System (Atlanta Medical Center and Atlanta Medical Center South) in 2022. Their closings have put increased financial and capacity pressure on Grady Memorial Hospital, the sole remaining Level 1 trauma center in the city. This means longer wait times and decreased access to care for all in the community. This is especially critical in what we deem as the “golden hour.” It is the time immediately after a medical emergency when timely intervention can significantly improve a patient’s survival and decrease long-term complications.

The American Medical Association (AMA) has expressed concern as the bill will limit access to care as millions will lose insurance and a decrease in federal support of medical student loans will worsen physician shortages.

The American Hospital Association (AHA) noted the financial strain on hospitals.

The National Academy for State Health Policy (NASHP) cited apprehensions about operational challenges states will have in implementing the bill’s requirements, especially as it relates to eligibility verification and data systems.

The National Medical Association (NMA), the nation’s collective voice of African American physicians, is alarmed because the bill will expand healthcare disparities and “harm our communities for decades to come.”

Non-profits such as Planned Parenthood are worried that the “bill will restrict access to essential healthcare services for low-income individuals, particularly those who rely on Medicaid for services like birth control, cancer screens and mental health care.” This is especially true as the Supreme Court decided in a June 2025 ruling that states can block the organization from receiving Medicaid funds, even if patients are seeking care unrelated to an abortion. Imagine how this will impact states like West Virginia where half of all births are funded by Medicaid.

As a hospital medical physician, I can foresee an already too common scenario becoming even more frequent: a person comes into the hospital with symptoms that have been worsening for months such as pain, edema or shortness of breath. They delayed seeing their healthcare provider in clinic and/or filling/refilling prescriptions due to the availability of clinicians and cost; particularly if they lost their insurance. Due to the worsening severity of the disease, their care team recommends medical management (medications) and not more aggressive treatment (like a procedure or chemotherapy) because the disease has progressed to a point where options are now too risky and less likely to be effective. Increasingly, hospice and palliative care are recommended.

This scenario will have broad consequences outside of that for the patient and their family. Someone will have to pay for the $204 billion in increased uncompensated care: $63 billion for hospitals and $24 billion for physicians. That someone is most likely you. Again, as states must balance their budget, the additional expenses will be laid at the feet of state taxpayers via an increase in income, sales, and/or property taxes.

Now more than ever, preventative care must be the focus of our nation’s healthcare system. Programs such as NEWSTART can lay the foundation to prevent, treat and even cure chronic disease. It is a “physician monitored, scientifically researched lifestyle-change program based on eight fundamental principles proven to help you achieve optimum health: Nutrition, Exercise, Water, Sunlight, Temperance, Air, Rest and Trust.” It is a means in which we can start to take control of our health, increase wellness, and decrease our reliance on costly pharmaceutical and advanced medical care.

My support of lifestyle modifications comes from personal experience. When faced with my own health challenges, my physicians were amazed at my rapid recovery and attributed it to years of a plant-based diet and regular exercise.

One other note, H.R.1 passed without compromise or input from members of any other party, because Republicans control the House of Representatives, the Senate, the White House, and the Supreme Court. While I have called out my fellow physicians in Congress, 50 Senators (with a tie breaking vote from the Vice President) and 218 Representatives voted for this bill. Your vote, or lack thereof, can change the course of your life and has changed the country.

My duty is not only as a physician to my patients, but as a daughter whose Heavenly Father requires much for the much I was given. I am to look after the orphans and widows (James 1:27), give openly to the needy and poor (Deuteronomy 15:11), and to consider the needs of others (Philippians 2:4). The parable in Luke 16:19-31 is a cautionary tale.