Every day I’m reminded of the consequences of cuts to Medicaid, Medicare, the Affordable Care Act (Obamacare) and indirect research funding. They cover the operating costs of our hospitals. More than 50% of our hospitals’ operating budgets are maintained by our tax dollars. They are publicly funded.

All too often we think of Medicaid and associate it with folks who are poor, people with disabilities and our seniors. Yes, Medicaid provides health care for folks, but we are all interconnected in ways that all of us desperately need to know when talking $880 billion in cuts to Medicaid.

In Maine, 76% of our hospitals at medium to high risk of severe financial problems. Nationwide, a staggering 703 rural hospitals are at risk of closure. Nationwide, one-fifth of our hospital spending in 2023 was Medicaid. A cut to Medicaid is a direct hit on the operating budget of a hospital, and that hospital provides health care for all of us.

In Maine over the past month, one hospital has announced it will close, as well as two birthing units. One hundred workers have been laid off, and at least one clinic has announced it will close. Emergency services have warned there will be delays in getting people to the hospital. Our second largest hospital system is consistently devastated financially.

We live in a rural state. We are a rural country because we are so large. Public transportation is not a reality in most of Maine and the gaps are significant nationwide. We must build our own networks to connect with each other. Until then people are stranded in emergencies and will continue to be as more hospitals are shuttered and more doctors disappear, as they will with $880 billion in cuts to Medicaid.

Nationwide it is estimated that between “2021-36 there will be a shortage of between 20,200 and 40,400 PCPs,” according to the Association of American Medical Colleges. This is just an assessment of primary care provider shortages. It does not include specialty care. Maine’s nursing shortage for this year was estimated to be 2,500 in 2021 and nationwide it is critical. The list goes on as you examine each segment of the health care workforce and the consistent challenge of adequately paying direct care workers.

The Energy and Commerce Committee is charged with making massive cuts to the federal budget during the reconciliation process. That is right now. So, I beg of you, if you want emergency care for your loved ones all across the country you get on the phone and you fight like hell for every last penny of Medicaid funding.

If you want your neighbor to get treatment from a disease like measles or cancer or diabetes then make a call. Gun violence discussion invariably comes down to mental health treatment and if we do seek to address gun violence we better have the care and health coverage in place. Cuts to Medicaid jeopardize treatment for so many, including those with substance use disorder and folks needing community supports like case management and group homes.

Health affects everything and everyone.

Talk to your neighbor. Talk to your town council. Talk to your state representatives and state senators. Talk to candidates and call your United States senators and representatives. Show up at their offices. Use every lever of power or access you have. Say it loud. Write it loudly in a letter to the editor in your local paper.

We are in an emergency and we must fight back. Right now the Republicans, President Trump and Elon Musk are detonating our public health infrastructure with these cuts to Medicaid. We can let it blow up or not. The time is now to act and act up to protect the health of all of us and save our hospitals and health care.