Protecting Access to Care and Medicaid from Cuts in 2025

U.S. Capitol Building, Washington, D.C.

At MaryCatherine Jones Consulting, LLC, we are deeply concerned about the proposed legislation known as the One Big Beautiful Bill Act, which recently passed the U.S. House of Representatives by a narrow margin and is now under consideration in the Senate. This sweeping reconciliation package includes significant cuts to Medicaid and other critical health care programs that would severely impact access to care for low-income and underserved populations across the country.

Among the most troubling provisions is the proposed $800 billion in cuts to Medicaid and the Health Insurance Marketplace. If enacted, these cuts could strip health coverage from nearly 11 million Americans. The consequences would be felt immediately in already overburdened hospitals, emergency rooms, and especially in Free and Charitable Clinics and Charitable Pharmacies—the frontline providers of care for the uninsured. These clinics, often operating on limited budgets, are already doing more with less. Increased demand due to coverage losses could overwhelm their capacity and compromise care quality and access.

Medicaid underfunding has long been a barrier to equitable health care. Many states rely on supplemental payment programs and provider taxes to help close these funding gaps. These mechanisms are not examples of fraud or waste—they are state-approved and federally sanctioned tools that support care delivery in communities where the need is greatest. The proposed legislation would impose new restrictions on these programs, worsening already inadequate Medicaid reimbursements and further threatening the sustainability of safety-net providers.

As consultants and advocates working alongside Free and Charitable Clinics, community-based health providers, and public health organizations, we urge federal lawmakers to reconsider the dangerous direction of this bill. These cuts not only put individual lives at risk—they also threaten jobs, economic stability, and the health infrastructure of entire communities.

We are particularly alarmed about the effects on rural health care providers, who often rely disproportionately on Medicaid funding to keep their doors open. Without adequate reimbursement and support, many rural clinics and hospitals could be forced to reduce services or shut down entirely—creating health care deserts in areas already facing provider shortages.

MaryCatherine Jones Consulting, LLC supports ongoing efforts to advocate for a Medicaid program that is adequately funded, fairly structured, and capable of meeting the health needs of vulnerable populations. We stand with our partners in the field in calling for:

• Preservation of SNAP funding and rejection of deep budget cuts

• Preservation of Medicaid funding and rejection of deep budget cuts and work requirements

• Strengthening of the National Health Service Corps (NHSC)

• Protection of state-directed payments and provider taxes that support local access

• Recognition of the essential role Free and Charitable Clinics and Charitable Pharmacies play in filling the coverage gap

  
  

We encourage clinic leaders and board members, public health professionals, community members, and advocates to contact their senators now. Your stories and your voices matter. Tell Congress: “Don’t Cut Community Care. Protect Medicaid.” The Association of Clinicians of the Underserved, has great instructions and a script for calling your US Senators and Representatives.

Now is the time to act.