How The Medicaid Cuts in the ‘One Big Beautiful Bill’ Could Devastate Black Americans

Medicaid Awareness Month was established to educate the public about Medicaid and its vital role as the nation’s largest source of health coverage, but this April, it carries particular urgency following Medicaid cuts that threaten to send shockwaves through Black communities nationwide.

Protect Our Care has noted that Republican budget proposals swung a heavy axe, aiming to chop $1 trillion from Medicaid, resulting in the largest federally supported healthcare rollback ever. According to the nonpartisan Congressional Budget Office, the cuts would be implemented over a 10-year span.

Established in 1965, Medicaid provides coverage to more than 75 million Americans. This includes families, children, seniors and people with disabilities. It has played a key role in reducing racial disparities in health coverage and improving access to care.

Higher Maternal Health Risks

Medicaid covers 41 percent of all births in the United States and 65 percent of births to Black mothers, according to Protect Our Care. During Black Maternal Week, The Root has spotlighted disparities in care and maternal mortality rates among Black mothers, noting that 80 percent of maternal mortality is preventable. Medicaid cuts further intensify concerns about maternal health.

Coverage Loss & The Uninsured Gap

Medicaid provides coverage for 13.2 million Black people, representing about one-third of the Black population. Protect Our Care reported that Medicaid expansion reduced the coverage gap between white and Black adults by 51 percent. Loss of Medicaid coverage could reverse these gains, leaving many without affordable health insurance.

Hospital Closures

According to Protect Our Care, Medicaid cuts under the Trump administration put more than 400 hospitals at increased risk of closure. These hospitals often serve large minority populations, and those in areas with higher Black populations are four times more likely to close than those in other areas. Protect Our Care warns that such cuts will worsen issues like patient mortality, longer wait times, and overcrowding.

Threat to Financial Security

In 2021, Census data showed that white households had ten times the wealth of Black households. Low-income households spend a larger share of their income on healthcare. Medicaid programs help reduce the racial wealth gap for those who qualify. Protect Our Care reported that people in states that cut Medicaid carry an average of $375 more in medical debt, while low-income adults in states with expanded Medicaid saw their debt decrease by about $1,140. For Black families already facing systemic economic inequity, these cuts are a threat to health and financial survival.