This week we are celebrating two important anniversaries. On July 30, Medicare and Medicaid will be 60 years old.
Signed into law by President Lyndon B. Johnson, these are two government health insurance programs that millions of people rely on to live. Medicare covers the elderly. Medicaid helps lower-income people including mothers, children, seniors and those with disabilities.
Since they were created in 1965, the two programs have become pillars of our country’s health care system.
As of January 2025, 71.4 million people were enrolled in Medicaid. In addition, 68.6 million people are enrolled in Medicare. That means 38% of our country’s population relies on these programs for their medical needs.
But this year, AFSCME is celebrating this special anniversary with mixed emotions. That’s because the joint legacy of Medicare and Medicaid is under threat.
Earlier this month, President Donald Trump signed into law the One Big Beautiful Bill Act (OBBBA). It will enact the most sweeping overhaul of Medicaid in history, which will also trigger drastic cuts to Medicare.
This law is as ugly as it gets. It means higher health care costs, longer waits in the emergency room, and fewer health care services for everyone. It will undo much of the progress we’ve achieved in improving the lives of working families, the elderly and people with disabilities.
These attacks threaten the legacy of Medicare and Medicaid, programs AFSCME members have long fought for. We must and will fight back.
The law is anything but beautiful
The anti-worker extremists who pushed the law did so to help their billionaire buddies. Specifically, this administration and its allies in Congress want to shower their ultra-rich friends with even deeper tax cuts at the expense of working people and retirees.
To pay for these billionaire tax cuts, the bill will kick 15 million people off their health insurance.
Among the most damaging provisions of the new law are work requirements for Medicaid recipients, stricter eligibility checks and higher co-payments — though the majority of people on Medicaid already work. Those provisions are cuts in disguise that will hurt the most vulnerable in our communities by making them jump through bureaucratic hoops tape to access the care they deserve. States will face tighter financing rules that will make it harder to continue providing this essential care.
Changes to Medicare begin as early as January of next year. OBBBA will make it harder for low-income seniors to pay Medicare premiums, deductibles and other out-of-pocket costs. Some immigrants, such as refugees and asylum seekers, who have been paying into Medicare for decades will lose eligibility.
Everyone will be affected
Even if you don’t rely on Medicare or Medicaid, your health care will be affected. People who get their health insurance through the Affordable Care Act will see their premiums go up, due to expiring ACA tax credits.
The loss of Medicaid funding will likely force hospitals and health care clinics — especially in rural areas — to close their doors, making access to health care even harder for people with private health insurance.
Health care workers in states across the country and other public service workers whose jobs rely on Medicaid funding will be affected as well. They may lose their jobs. Or they may lack the resources to provide the public services their communities rely on.
Those most vulnerable will be hurt the most
Many people with disabilities rely on Medicaid for their health insurance. As a result of OBBBA, they will find it harder to prove their eligibility. In addition, states may be forced to cut home- and community-based services that help people with disabilities receive support at home and preserve their dignity and independence.
Put this all together and we’re talking about millions of people — including children, the elderly and individuals with disabilities — who, over the next decade, will:
- Find it harder to access health care;
- Obtain and keep their health insurance;
- Pay more for health care when they do find a provider;
- Lose the services they have come to rely on.
All this to make our country’s richest people even richer. So people like Elon Musk can build more rockets to one day fly to Mars. So people like Jeff Bezos can stage even more lavish weddings in exotic locations.
It’s time to fight back and hold Congress accountable for this disastrous bill. Do your part, join the AFSCME Get Organized campaign.