1. United States
2. Wash.
3. Letter

Cuts to Medicaid expansion under the Affordable Care Act (ACA) would result in staggering coverage losses for millions of low-income Americans, disproportionately affecting certain states more severely. Proposals to eliminate the 90% federal matching rate for Medicaid expansion or implement funding caps would force states to either increase their own spending by billions or terminate their expansions entirely. This could cause an estimated 20 million people to lose their health coverage. The impacts would be uneven across states. In 12 expansion states with "trigger" laws, coverage would be automatically and swiftly terminated for residents if the federal government reduces its funding commitment. Three other expansion states enshrined Medicaid expansion in their constitutions, potentially setting up prolonged legal battles as states struggle to maintain coverage amidst massive budget shortfalls from federal cuts. Residents of non-expansion states, which are already among the poorest, would continue lacking affordable healthcare options as federal funding incentives disappear. Geographic and wealth inequalities in access to care that the ACA alleviated would resurface. Any reductions to Medicaid, SNAP, or other vital programs supporting vulnerable populations are unacceptable, particularly if intended to finance tax cuts disproportionately benefiting the wealthiest individuals and corporations. I want you to focus on your constituents, not the wealthiest 400 billionaires in the U.S. We elected you, not them.