The Hidden Costs of Budget Cuts: Medicaid, Medicare, and Women’s Health

When the traditional model of the U.S. healthcare system failed the people it was meant to serve, Medicaid and Medicare functioned as a safety net to catch those that fell through the cracks. To several, these health support programs may sound like an abstract idea, only tangentially related to them; however, for about 40 million women, Medicare and Medicaid serve as a foundation of health.

According to the Georgetown University Center for Children and Families, women construct the majority of all Medicaid enrollees and Medicare beneficiaries, providing essential support and access to quality care. From access to family planning and maternity care benefits, long-term care services, preventative health services such as heart disease screenings and well-women visits, to treatment for chronic conditions and mental health support, Medicaid is a cornerstone of care for women across every stage of life. So, when lawmakers made the decision to pull back funding through the One Big Beautiful Bill Act, which goes into effect 2027, women will be the first to feel it.

Maternal Health

Maternal health stands to experience one of the hardest hits. Medicaid is the primary source of coverage and the largest single payer for pregnant women’s health care nationwide, paying for at least 41% of all births and combating the highest rates of maternal mortality among any high-income country. Though the external disparity is high, the internal discrepancy is even higher, with Black mothers being affected at three times the rate of their White counterparts. An already flawed system, removing additional funding will not only exacerbate the negative distance on both sides but also deteriorate the quality of care these mothers rely on.

Medicaid plays a vital role in supporting mothers before, during, and after pregnancy, covering everything from prenatal checkups to postpartum mental health care. These services save lives, lowering maternal morbidity and mortality, reducing recovery times, showing fewer adverse outcomes in subsequent births and negative impacts on infant health. Mental health issues, including suicide and substance use disorders, are the leading cause of pregnancy-related deaths. Forty states and DC have adopted the ACA’s Medicaid Expansion under the Affordable Care Act, making continuity of mental health services, from before a woman conceives to after the postpartum period, possible.

Long-term Care: Women Live Longer Medicare is just as essential to the overall state of women’s health. Because of their generally longer lifespan, women over the age of 65 represent more than half of Medicare enrollees. That older age is often accompanied with more complex health needs, from managing chronic illnesses to requiring prescription medications and eventually long-term care. Medicare cuts mean higher out-of-pocket costs for doctor visits and hospital care, reduced access to prescription drugs under Medicare Part D, and a shrinking support for long-term care services.

Art by Shea Davis

Women in particular rely heavily on services such as nursing home or assisted living care, home health visits to help with daily tasks, and ongoing rehabilitation after falls or fractures. They also face greater needs for chronic disease management, prescription drugs for conditions like osteoporosis and arthritis, and mental health services to address higher rates of depression and dementia. Toward the later stages of life, women are also more likely to require palliative and hospice care, reflecting both their longer lifespans and greater likelihood of living with extended illness.

Women are Hit Multiple-Fold

Rooted in long-standing inequalities, economic disparity plays a role. Women still earn less, on average, than men and are more likely to work in part-time or low-wage jobs that don’t provide health insurance, making health coverage programs all the more essential.

Caregiving responsibilities layer an additional burden. Women are more often the ones caring for children, elderly parents, or family members with disabilities. If the primary caregiver can’t access preventative care, mental health services, or treatment for chronic conditions, the ability to fulfill that role becomes compromised. These cuts do not just weaken women’s health, they also disrupt the community they care for. The economic and social factors in tandem with biological ones explain why women bear the heaviest burden when health coverage is reduced.

In Context

Cuts to Medicaid and Medicare trades saving lives for saving a few dollars and cents. Put into context, these reductions determine whether mothers will be able to survive childbirth, whether elderly women can afford prescriptions and nursing home services, whether families have to struggle with the possibility of going bankrupt to receive basic care. Improving women’s health, and by extension community health, means that Medicare and Medicaid is part of the solution. Improving health outcomes never means taking away the services that provide them.