Pennsylvania officials, medical providers sound alarm over Medicaid cuts
A Pittsburgh-area state representative joined nonprofit health care advocates Wednesday to respond to a Congressional budget blueprint that tees up major cuts to Medicaid. Pennsylvania Democratic state Rep. Arvind Venkat, who represents the North Hills suburbs, accused congressional Republicans and the Trump administration of slashing Medicaid funding without an explanation to the public.
“I found it very telling that yesterday, President Trump made zero mention of Medicaid cuts,” Venkat said, referring to President Trump’s speech to Congress Tuesday. “It's an embarrassment to them.”
Venkat, who is also an emergency room physician, joined Protect Our Care Pennsylvania, an affordable health care nonprofit, as well as other Pennsylvania medical providers and a former secretary of Pennsylvania’s Department of Human Services at a virtual hearing Wednesday about the future of Medicaid.
The Congressional budget resolution passed last week calls for $2 trillion in spending cuts. $880 billion of those cuts must come from the House Energy and Commerce Committee, which oversees Medicaid. Some Republicans have said they would not support cuts to Medicaid, Medicare or the Children’s Health Insurance Program. But it’s unlikely that lawmakers will be able to find enough cuts to total the $880 billion target without taking from the program.
And that could mean many of Pennsylvania’s more than 3 million Medicaid recipients could lose access to coverage. Venkat said without Medicaid, hospitals will see more emergency room visits from patients who can’t afford the cost of care.
“I practiced in this state before the Medicaid expansion and when the emergency department was the access point for many of my fellow Pennsylvanians for healthcare because they had no other way to pay for coverage and no other place that would see them,” Venkat said.
He recalled the story of a patient who came to the emergency room with severe back pain who avoided seeking care due to unpaid medical debt. Venkat said it was later discovered that her pain stemmed from widely metastatic breast cancer.
“She was scared of seeking care and as a result she only sought care in the emergency department when it was frankly too late,” he said. “That is the future that we’re looking at if these cuts go through.”
Venkat said not only will loss of Medicaid insurance lead to delayed care for the uninsured, but people with private insurance may be stuck footing the bill as the rate of uncompensated care, which is when a patient is treated but can’t pay, increases. And that could mean higher insurance premiums.
And less funding for Medicaid can also be disastrous for the bottom line of smaller hospitals, according to Pennsylvania’s former Secretary of Human Services Teresa Miller. After Medicaid was expanded in Pennsylvania a decade ago, hospitals statewide saw a 32% decrease in uncompensated care. She said the biggest impact was felt in rural areas where hospitals are fewer and farther between.
Miller said older Pennsylvanians often use Medicaid to make up for the gaps in Medicare. And without that, some may struggle to get care.
“Rural residents enrolled in Medicaid at higher rates than urban areas following Medicaid expansion,” she said. “These residents are older. They're prone to health issues and financially more disadvantaged.”
President Donald Trump arrives on the South Lawn of the White House, in Washington, Monday, Feb. 10, 2025.
Seniors and people with disabilities are about 27% of the total Medicaid population in Pennsylvania, but they account for 65% of Medicaid expenditures, Miller said.
In response to outcry from Democrats, the Trump administration and Republican leaders in Congress have repeatedly vowed that there will be no cuts to Medicaid, Medicare or Social Security; and that reductions will reflect the removal of fraud, waste and inefficiencies.
But Miller questioned how lawmakers could find $880 billion in wasteful spending and inefficiencies without slashing critical care programs.
“There is no conceivable way that cuts of nearly a trillion dollars would only remove fraud, waste and abuse,” Miller said. “It’s ignoring the reality of how the Medicaid program works and the impact that it has on people’s lives.”
She added that safeguards already exist to root out fraudulent claims and cut down on wasteful spending, noting the Pennsylvania Attorney General’s office regularly investigates fraud.
Such investigations happen at the federal level, too. An audit from 2022 found that Pennsylvania’s school-based Medicaid program claimed $551.4 million in federal funds over four years that it did not have sufficient documentation for; but the state claimed the missing documents were related to student individualized education program materials, which were not shared as a matter of privacy policy.
Concerns about Medicaid were echoed at an event in Pittsburgh Wednesday attended by Gov. Josh Shapiro. When asked by reporters about how the state would respond to lower Medicaid funding, he said he’s been lobbying lawmakers and the Trump administration.
“I’ve been engaged with our federal delegation and engaged with members of the Trump administration to let them know… that [this] is going to have a profoundly negative impact on up to 3.2 million Pennsylvanians,” he said. “It’s just stupid and it’s wrong. It’s not smart policy.”