GOP considers cutting millions in Medicaid funding; rural health may pay the price

 Georgetown University graph, from 2022-2023 American Community Survey data

President Donald Trump has a big agenda that needs big funding. To pay for Trump's plan, GOP members are considering axing chunks of federal Medicaid spending, which could "put the residents of small towns and rural communities and their health care systems at serious risk," report Georgetown University researchers.

Rural Americans who are non-elderly adults and children "are more likely to rely on Medicaid/CHIP (Children's Health Insurance Program) for their health insurance," researchers explain. Medicaid reductions could be especially harmful for:

• Children in Arizona, Florida, North Carolina, Virginia, South Carolina, California, Minnesota, Georgia, South Dakota and Alaska.
• Adults in Arizona, New York, Washington, Texas, Kentucky, Virginia, Louisiana, Oregon, South Carolina and Montana.

Medicaid reductions would be particularly harmful for rural children in 10 states.
 (Georgetown University graph, from 2022-2023 American Community Survey data)

Part of the reason many rural residents rely on Medicaid is because their incomes tend to be lower and they lack "access to employer-sponsored health insurance, meaning that public coverage such as Medicaid and the Children’s Health Insurance Program fill an even more critical role in these areas than in other areas of the country," according to the Georgetown University report. "While uninsured rates have come down significantly since passage of the Affordable Care Act, they remain higher in small towns and rural areas."

Siphoning millions in Medicaid funding to pay for other priorities "poses a very severe threat to rural communities," researchers add. "Hospitals and other providers in rural communities are already operating on tighter margins and disproportionately rely on Medicaid for their patient revenues. . . . Large cuts will have dire consequences for communities that are already struggling."

An Oregon Democrat won working-class votes in a 'red' U.S. House district; she wants more 'normal people' to be elected

Gluesenkamp Perez would like more 'normal people' elected
into Congress. (Marie Gluesenkamp Perez press photo)

As Democrats look for ways to regain footing with working-class voters, Rep. Marie Gluesenkamp Perez, a Democrat from a previously red district in Oregon, is a living example of changes her party may need to embrace if it wants to gain votes from people who "work for a living," writes Jason Zengerle for The New York Times. "Before she was elected to Congress, in 2022, Gluesenkamp Perez ran an auto-repair shop with her husband; her professional and personal acquaintances still largely consist of people who work in the trades — construction, carpentry, woodworking."

Gluesenkamp Perez doesn't think or act like many other politicians. Zengerle explains, "She hired her legislative director, in part, because the woman drove a Toyota Camry with 200,000 miles on it. 'That says a lot,' Gluesenkamp Perez explains. But what really sets her apart is the way she thinks about the federal government itself — which she believes is woefully out of touch with the needs of working-class Americans."

She has given voice to issues that reflect the needs of those who voted her into office. "While her opponent [Joe Kent] asserted that the 2020 election was stolen and that Dr. Anthony Fauci belonged in prison, she focused on the concerns of the community she knew," Zengerle adds. "Her biggest issue was pushing for 'right to repair' laws, which mandate that consumers have access to repair tools for everything from their smartphones and home medical devices to their cars and tractors." Gluesenkamp Perez told Zengerle: “We’re more and more surrounded by these black boxes that we have no influence over. I think it’s the American ethos that we know how to fix [expletive].”

While working-class connections got her into Congress, Gluesenkamp Perez found it hard to connect with her fellow politicians. "One of the few friendships she did strike up was with Jared Golden, a third-term Democratic representative from Maine," Zengerle writes. Golden's history included becoming leader of the Blue Dog Coalition when only seven members remained. "As the head of the Blue Dogs, he recruited Gluesenkamp Perez and Mary Peltola, who represents Alaska’s lone House district, to be his co-chairs. . . .The new Blue Dogs wanted to make it possible for more people like themselves ('normal people,' Gluesenkamp Perez calls them), from more districts like theirs, to get elected to Congress."

But standing up and speaking her mind has yet to have the legislative impact Gluesenkamp Perez wants. "The signature bills she has introduced or supported — table saws, right to repair, one to expand Pell grants to cover skills training at community colleges — are stuck in legislative purgatory," Zengerle explains. Her "biggest problem at the moment is Joe Kent, who is running again. This time, of course, Trump will also be on the ballot, which means Gluesenkamp Perez will need a good number of ticket-splitting voters to stay in office."

Some say she can't win re-election. To that end, she said: “All of the eggheads and all of the economists and all of the statisticians said we couldn’t do what we did. But you all showed up, and you believed it. Nobody saved us but us.”