Rural health clinics like mine will bear the burden of Congress’s Medicaid cuts

The “$1.5 trillion in tax cuts” that Congress’s “Big Beautiful Bill” seeks to extend is not merely a fiscal policy; it is a profound sacrifice. 

This sacrifice will not be borne by those who stand to gain, but by the very fabric of our society: our key social programs like Medicaid and SNAP benefits. The predictable outcome is a further funneling of wealth into the pockets of high earners, at the direct expense of the already threadbare social safety net that supports communities across our nation. As the director of a free primary care facility, I am dismayed by the callous lack of compassion Congress is demonstrating for financially strapped Americans.

The burden of care, inevitably, will fall upon the shoulders of free clinics like the Downtown Clinic in Laramie, where I have worked for over a decade. For the low-income, uninsured individuals we serve — those without Medicare, Medicaid, or VA benefits — the emergency room is often their only other recourse. We strive to provide high-quality, integrated healthcare, but when the Congressional Budget Office estimates that this bill would remove 10.9 million people from Medicaid and 5.1 million from the Affordable Care Act, it forces a chilling question: Where will these 16 million vulnerable Americans go?

In America today, 2 million people already receive essential care through free clinics like ours. Last year alone, the Free Clinic Association reported 6 million patient visits. We are proud to do this vital work, and 90% of our funding is derived from privately raised dollars. But how, I ask, do you expect an additional 12 to 16 million people to enter this system without a shred of additional financial support? This puts clinics like ours in an utterly precarious situation. It is, as I see it, nothing less than a cost shift from the federal government, designed solely to funnel tax cuts to the wealthiest Americans. That is not the America I believe in.

The damage extends catastrophically to rural healthcare. It’s estimated that this bill will lead to over $50 billion in lost Medicaid reimbursements over the next 10 years. The proposed $15 billion rural healthcare fund is, quite frankly, a disingenuous band-aid — an admission by our representatives in Congress that they recognize the harm this bill will inflict upon rural communities. This meager fund doesn’t begin to cover the projected losses, nor will it prevent the eventual shutdown of vital rural hospitals. If Congress truly wished to support rural healthcare, they would ensure people have access to healthcare in the first place, rather than offering inadequate props after inflicting such profound damage.

The America I was raised to believe in is one that values communities and supports neighbors. Growing up in Wyoming, at an elevation of 7,000 feet, if you saw a car on the side of the road in the winter, it could literally be a life-or-death situation. You didn’t hesitate; you pulled over, checked on them, offered help, a tow, or a ride to town. You checked in on your neighbors, feeding their animals when they were away. The values of looking out for each other, of community responsibility, are core to Americans, especially in rural communities. We must continue to embody that spirit.

This bill does not. There is a direct, undeniable line from the cuts in Medicaid and SNAP benefits to the enrichment of the richest few. Is this truly what Congress desires for our nation? I believe the American public does not want more income inequality. They want a country where we care for our neighbors, where a social safety net supports those in need, and where healthcare is a right, not a privilege reserved for the wealthy. 

It’s time for Congress to listen to the American people and reconsider a bill that fundamentally betrays our shared values.