Federal cuts to Medicaid would be devastating to Maine’s children. Sen. Susan Collins was right in opposing the budget resolution earlier this year, correctly warning that it would destabilize health care by forcing deep cuts to Medicaid. Unfortunately, the resolution passed in the House, and significant cuts to Medicaid are now being considered.

While some claim these proposals simply add work requirements for adults or reduce provider taxes, the result would be major funding losses that directly harm Maine children. After nearly 30 years as a pediatrician in Maine, I know there is no way to shield children from these cuts, even if they are not the explicit target.

A Kaiser Family Foundation study estimates that federal Medicaid cuts from the House Reconciliation Bill would reduce federal Medicaid spending in Maine by 9% — or $3 billion — and cut enrollment by 10% (42,000 individuals) over the next decade.

Medicaid is not just an insurance program; it’s the foundation of pediatric care in Maine. It ensures access to dental, vision and hearing services, as well as comprehensive care for children and youth with special health care needs (CYSHCN), many of whom require services that private insurance doesn’t cover. Every child in Maine will feel the effects of these cuts because Medicaid funding supports the entire pediatric health system, from individual practices to children’s hospitals.

As these proposals move forward, I want to highlight three particularly harmful aspects, and urge Maine’s U.S. senators to reject any plan that cuts Medicaid.

First: work requirements. Nearly all Medicaid enrollees between ages 19 and 64 are already working. Adding work requirements only creates more bureaucratic red tape, causing eligible, working adults to lose coverage when they miss paperwork deadlines or encounter administrative hurdles. Even with proposed exemptions for parents and caregivers, many who should qualify for exemptions will fall through the cracks and lose coverage, with downstream effects on their children’s access to care and family stability.

Second: cutting or eliminating provider taxes. These taxes are a critical, long-standing way for states to fund their share of Medicaid spending. While most state Medicaid funding comes from general revenues, states like Maine also rely on provider taxes, local government funds and other dedicated sources to sustain the program. If federal law freezes or eliminates provider taxes, Maine would face an impossible choice: replace the lost revenue with new taxes, or make deep cuts directly to Medicaid services.

Third: cuts to Medicaid will reduce essential benefits, especially for vulnerable children. Community and home-based services for CYSHCN, children with behavioral disorders and children in foster care — 99% of whom rely on Medicaid — will be at particular risk. These services help keep children safely in their homes, schools and communities, avoiding more expensive and traumatic institutional care.

Medicaid is the backbone of health coverage for roughly 140,000 Maine children, 54% of all children in our state. The changes proposed under the One Big Beautiful Bill Act (HR 1) are, in reality, cuts to Medicaid. While they may be packaged as “reforms,” the result is clear: they will slash funding, destabilize state programs and directly harm children and families across Maine.

As a pediatrician, I see every day how Medicaid supports entire families — not just children, but parents and caregivers whose health and stability directly affect a child’s well-being. For generations, MaineCare has been a lifeline for Maine families. Any cuts to this program will carry lasting consequences for our communities, not just today, but for years to come.

I urge all Mainers to contact our U.S. senators and ask them to oppose any federal proposal that cuts Medicaid funding or limits access to services for Maine children and families.