The House budget advanced on May 22 proposes cuts of $1.1 trillion out of Medicaid and the Supplemental Nutrition Assistance Program (SNAP) over the next 10 years; $880 billion in cuts to Medicaid and $230 billion in cuts to the SNAP program.
The impact of the extreme cuts to Medicaid proposed by the House budget would devastate families and communities, rural and urban, across this country. Additional cuts to SNAP will irreparably harm Michigan families who need basic food support and also increase childhood hunger across our state.
Medicaid is the primary program providing comprehensive health care coverage that supports about 80 million low-income people in the United States. Also, and usually not discussed, is that Medicaid is the primary source of funding for nursing home care in the US, particularly for low-income individuals and those with disabilities who need long-term care. Medicaid provides coverage for nearly 63% of all nursing home residents in this country and covers 70% of the costs, with the average cost of a nursing home stay amounting to over $90,000 per year.
Medicaid also covers one-in-five people living in the US, covers four-in-10 children, eight-in-10 children in poverty, one-in-six adults, and six-in-10 non-elderly adults in poverty. Medicaid covers 44% of non-elderly, non-institutionalized adults with disabilities, who are defined as having one or more difficulties related to hearing, vision, cognition, ambulation, self-care or independent living.
In addition, Medicaid covers 41% of all births in the United States, nearly half of children with special health care needs, five-in-eight nursing home residents, 23% of non-elderly adults with any mental illness and 40% of non-elderly adults with HIV. Medicaid also pays Medicare premiums and often provides coverage for services not covered by Medicare for nearly one-in-five Medicare beneficiaries (13 million people).
In Michigan, our total population is 10.1 million people with over 2.6 million residents covered by Medicaid. That’s 26% of Michigan’s population. This includes individuals enrolled in the traditional Medicaid program and the Healthy Michigan Plan (Medicaid expansion).
In 2025, Michigan’s Medicaid budget is approximately $27.8 billion. A majority of this funding, around 70% or $19 billion, comes from the federal government. The Medicaid program in Michigan is the largest single spending category within the Michigan Department of Health and Human Services budget. In FY 2023, total US Medicaid spending reached $880 billion. The federal government contributed 69% of that and the states paid 31%.
The impact of the Medicaid cuts proposed by the House budget would impact a quarter of Michigan’s population. This means Michigan children and adults with Medicaid will lose benefits, which will impact their ability to see a physician, get prescriptions, get tests and procedures, receive adequate hospitalization services, receive mental health services, etc. This could lead to early death and preventable diseases for Michiganians.
In 2023, the Supplemental Nutrition Assistance Program (SNAP) served an average of 42.1 million people per month nationwide. This represents approximately 12.6% of the US population. SNAP is the largest nutrition assistance program in the country and helps low-income individuals and families afford food and other essentials like rent and medical bills. Federal SNAP spending totaled $112.8 billion and benefits averaged $211.93 per participant per month nationally.
As of April 2023, over 1.3 million Michigan residents – including over 550,000 children – received SNAP benefits at an average monthly amount of $170. Given one-in-six children in Michigan already face hunger daily, according to Feeding America, how is this helpful? What’s the plan for these newly food insecure Michigan children?
As a physician practicing for the last 39 years in Detroit, I run a federally-qualified health center (FQHC) clinic (Health Centers Detroit) consisting of eight primary care physicians serving 10,000 low-income residents of whom 70% are insured by Medicaid and 10% are uninsured. I worry that these cuts Congress is considering to the Medicaid and SNAP programs will devastate Michigan families who are financially living on the edge already and barely able to address their daily basic needs.
Cutting Medicaid and SNAP by $1.1 trillion and taking this money from low and middle-income Americans and Michiganians and giving it to the wealthiest people in the country and state is not who we are as Americans. We are not a cruel people and did not vote for a Congress to intentionally and knowingly hurt the most vulnerable people in our country and communities.
Our nation’s character and a source of national pride has always been about being the “good guy”, caring beyond oneself, supporting families and community, and our willingness to be accountable for the well-being of the larger community by operating in service for those around us. We continually drive efforts to improve not only our own lives, but also the lives of our fellow Americans. These are the founding values of this country.
We at Health Centers Detroit are proud to serve our community and to provide care to everyone who needs it. But, our ability to help those in need rests on a consistent relationship with the Medicaid program and basic food programs. We think that retaining local health care options and basic food support for our low-income neighbors is worth protecting, so please let your representatives and senators in Congress know that Medicaid and SNAP need protecting, too.
Dr. Herbert C. Smitherman Jr. is a professor of medicine at Wayne State University School of Medicine/ Detroit Medical Center, and the President and CEO of Health Centers Detroit Medical Group, Inc. In addition, he serves as the CEO of the Michigan Area Health Education Center, Southeast Regional Center in Detroit. The program seeks to expose disadvantaged students to health care opportunities, expand the number of underrepresented minorities in the health professions, and encourage students and health professionals to work in areas that need greater access to primary care providers.