FACT SHEET: People of Color Face Coverage Loss and Higher Costs Thanks to Republicans Gutting Medicaid

This April is the 9th Medicaid Awareness Month, and Donald Trump and congressional Republicans are celebrating it by driving up costs and stripping coverage from communities of color. Republicans slashed over $1 trillion from Medicaid to bankroll tax breaks for billionaires and big corporations, putting the lives of millions of Americans in jeopardy. Not only is Medicaid the nation’s largest health insurance program, providing health care for nearly 70 million people, it is also a lifeline to affordable care for Black, Latino, and Indigenous communities in rural and urban America. These communities continue to face the effects of structural racism, such as lower rates of coverage and worse health outcomes, and Medicaid is essential to tackle them.

But instead of strengthening or protecting it, Republicans are gutting American health care. Their cruel agenda will rip coverage away, raise costs, and hit communities of color the hardest at a time when no one can afford it. This is a deliberate choice by a Republican administration that is going the extra mile to strip people of color of quality and affordable care.

By the Numbers

• Nearly A Third Of All People Of Color Count On Medicaid, Including Half Of All Children Of Color And More Than A Quarter Of Seniors Of Color.
• Nearly A Third Of Latino Americans Count On Medicaid. Medicaid Covers 20.3 Million Latinos.
• Nearly A Third Of Black Americans Count On Medicaid. Medicaid Covers 13.2 Million African Americans.
• 1 In 2 Native American And American Indian People Are Enrolled In Medicaid. Medicaid Covers 700,000 Native Americans.
• 2 In 5 Asian Americans Are Enrolled In Medicaid. Medicaid Covers 3.5 Million Asian Americans.
• 1 In 3 Native Hawaiian And Pacific Islanders (NHPI) Are Covered By Medicaid. 200,000 Native Hawaiians And Pacific Islanders Count On Medicaid.
• Medicaid Cuts Made It Impossible For 10 Remaining States To Expand Medicaid, Leaving Over 1.3 Million Americans Without Coverage. If Medicaid Were Expanded In Holdout States, More Than 1.36 Million Uninsured Adults Could Gain Coverage, Of Whom 60 Percent, Or 780,000 People, Are People Of Color.

GOP Cuts to Medicaid Threaten Any Chance of Progress in Reducing Health Disparities. Increasing Medicaid access is the single most important action available to expand coverage and address access to quality care as a driver of health. Research confirms that Medicaid expansion saves lives and drastically reduces racial/ethnic health coverage disparities. States that expanded their Medicaid programs saw a 51 percent reduction in the gap between uninsured white and Black adults after expansion, and a 45 percent reduction between white and Hispanic/Latino adults. Now, due to Trump and Republican cuts to Medicaid, states like Idaho and Oklahoma are considering repealing Medicaid expansion entirely and other states are being forced to either raise taxes or cut other programs to make up for the increased costs.

GOP Cuts to Medicaid Will Lead to Worse Health Outcomes for Black Mothers and Children. Children of color disproportionately rely on Medicaid coverage, making robust Medicaid access a critical racial/ethnic justice issue for American children. Children of color make up nearly 52 percent of all American children, but nearly 67 percent of the children on Medicaid. This coverage not only provides health coverage in the immediate term but also provides significant long-term benefits, such as being less likely to be hospitalized and more likely to graduate from high school and college. Around 41 percent of all births in the United States were financed by Medicaid, but this number increases to 65 percent of births from Black mothers. With 80 percent of maternal mortality deaths being preventable, the GOP’s draconian cuts to Medicaid will only increase the disparity in maternal mortality rates and lead to more needless deaths among Black mothers and children.

Work Requirements Will Disproportionately Affect People of Color, Even Though They Are Working. As an example, up to 85 percent of the Native American and American Indian population in places like Louisiana, where 60 percent of all Native Americans and American Indians are on Medicaid, will be affected by new work requirement rules imposed by Republicans and the Trump administration. These work requirements will target individuals in tribal communities who often have subsistence jobs which do not offer the documentation required to fulfill work requirements. This doesn’t stop at individuals losing coverage, though, as these funding cuts will also be seen in Indian Health Service (IHS) funding, of which Medicaid covers around 13 percent. This means that even Native Americans and American Indians not on Medicaid will see their coverage worsened, care cut, and prices hiked.

GOP Medicaid Cuts Will Disproportionately Impact the Hospitals Communities of Color Rely On. Over 400 hospitals across the country are at risk of closure or cuts after Republicans gutted $1 trillion from Medicaid. According to Public Citizen, the hospitals that serve communities with a larger share of Black and Hispanic residents are at greater risk of closing or cutting services. Communities with the highest proportion of Black residents face four times the odds of hospital closures compared to those with the fewest Black residents, and Medicaid cuts have only further exacerbated an access to care crisis that has been growing across the country. Medicaid provides vital funding to hospitals, particularly those in marginalized communities. Hospital closures lead to crowded emergency rooms, longer ambulance waits, longer hospital stays, fewer available patient beds, and higher patient mortality among Americans. Some rural counties have already been forced to hike taxes to make up for the funding shortfall. The impact won’t just be limited to rural areas, though. An analysis by Harvard researchers found that 85 percent of hospitals most exposed to the Trump-GOP Medicaid cuts are in urban areas. These hospital closure risks are not colorblind either; around 20 percent of all hospitals at risk of closure are within just five states where 42 percent of Black Americans reside.

Source: Center for Healthcare Quality and Payment Reform and U.S. Census Bureau, 2024 Population Estimates

Medicaid Cuts Undermine the Financial Security of Families Of Color. The annual median household income for white Americans was nearly $20,000 higher than for Hispanic/Latino households and nearly $30,000 higher than for Black households. Programs that boost financial well-being for everyone then undoubtedly help to lower the racial income gap; after enrolling in Medicaid, a 2018 study found that low-income adults had $1,140 less in unpaid debt in states that expanded Medicaid. Over the past decade, research has shown the gap in medical debt between Medicaid expansion and holdout states has grown approximately 30 percent. In 2020, Americans living in holdout states carried an average of $375 more in medical debt than their counterparts in expansion states. Now, though, with Trump and Republicans putting Medicaid expansion at risk, slashing $1 trillion in Medicaid funding, and forcing states to implement draconian work requirements, the inequality-reducing effects of Medicaid are set to be halted if not reversed.