We must resist cuts to Medicaid 

The author is a former 2nd vice president of District Council 37 Local 1549. He was also a member of the Health Care Transition teams of former Governor Elliot Spitzer and Mayor Eric Adams.

It is ludicrous for the Trump-Musk government to say they just want to cut Medicaid “fraud and waste." I know this from my 40-plus years of being involved in health care policy, working at Bellevue Hospital, the country’s oldest public hospital, as well as being a patient (Bellevue saved my life from a near fatal asthma attack in 1985) and having had close relatives, including my mother, on Medicaid.

Such "waste" rarely exists. Just 5.1 percent of Medicaid costs were in error but most of those were not fraud-related, according to KFF health policy research. Much of that is recoverable upon reviews. Contrast that to the 20 percent of private for-profit health insurance claims found to be fraudulent, according to Forbes Magazine.

Medicaid is the least expensive health insurance system in the country. The overhead just for "administrative costs" is just 2 to 5 percent. Those costs reach upward for 20 and 30 percent at private profit-oriented health care institutions and insurance companies.

The program also creates economic activity in local communities. Medicaid contributes to the local economy more than $2 for every dollar spent on the program. Cuts in the budget could adversely affect these communities. For instance, when Bellevue Hospital closed temporarily following Superstorm Sandy, the local eatery nearby closed permanently.

Eligibility for the Medicaid program requires a lot of documentation and is monitored. Statistical data is available for public inspection.

I know all this since I represented and testified at a City Council hearing on behalf of the eligibility specialists for Medicaid working in the city’s Human Resources Administration as a union local vice president for 20 years while we represented them. The little fraud that exists is committed mostly by shady providers and pharmacies, not patients. Usually, those responsible are caught and prosecuted. Most of the patients are children and elderly. That is where most of the costs for care goes.

To demand that Medicaid recipients have a job is absurd since the program chiefly benefits low-income earners and the poor. If that became the condition for eligibility, then those people cut off from the program would be uninsured and only be able to go to an emergency room for care. That might help with their initial health issue, but they would not be eligible for follow-up aftercare and monitoring. 

It would also lead to higher insurance rates for all of us since hospitals would have to charge insurance companies at a higher rate to make up for lost non-reimbursable funds. We all would be paying higher insurance premiums as a result.

Medicaid is the lifeblood of our care for the elderly and disabled in long-term care. The workers within the system are underpaid already, whether they work for an institution or in home care. To cut "waste" is to cut staff, salaries, or services. In any event, the patients lose.

The number of people on Medicaid in New York State is just over 4 million or 20 percent of the population. 2.9 million of them of the 10 million people living in New York City are on Medicaid. Health care facilities would have to institute staffing and other cuts. Some likely would have to close. 

“We’re certainly very, very worried, given the size of the cuts that have been talked about,” Dr. Mitchell Katz, the president and chief executive of NYC Health + Hospitals, testified at a recent City Council hearing on the health care system’s proposed Fiscal Year 2026 budget. 

The potential cuts, he said, could mean “hundreds of millions of dollars” in losses for the health care system, likely leading to reduced services. Jobs could be lost. The Commonwealth Fund estimates that 72,000 healthcare jobs could be lost in New York State because of the proposed cuts.

Health care facilities would have to cut services and some would close. A CBS news report found that almost 50 hospitals have closed in New York State since 2000 already. The City news site reported that more than a dozen have closed in New York City alone since then. Beth Israel Hospital in lower Manhattan is on the brink of closure and SUNY Downstate in central Brooklyn is at risk also.

The budget cuts are being proposed by the Trump-Musk administration to ensure that the very rich get further tax cuts. It is about the rich getting richer at our expense. Any money we might get from such a tax cut is minuscule compared with what the wealthy would derive or to the amounts we will have to pay out of pocket for health care in this country. The United States has the highest costs for care while ranking 20th in health care outcomes! The Trump-Musk policies regarding Medicaid would make things worse.

The Republicans’ claims of fraud and waste are phony. That is evidenced by Health and Human Services Secretary Robert Kennedy Jr.’s recent announcement that HHS inspector generals would be among the estimated 20,000 laid off from the department. This is more about gaining that much more wealth for the country’s 814 billionaires.

The proposed cuts to Medicaid, like those to other programs, must be fiercely opposed. 

If you agree, then please join me and thousands of others at Bryant Park in Manhattan at a 1 p.m. rally Saturday, April 5, against these and other cuts by the federal government.