Rallies in Washington, D.C.

Protests in Warren.

Macomb County officials and agency representatives who work with the millions of Michiganders, who would bear the brunt of cuts to Medicaid rumored to follow the budget resolution approved by the U.S. Senate and U.S. House, have been gathering to advocate on behalf of recipients.

“I’ve had people tell me not to worry, all of these are just proposed,” said Lisa Lepine, executive director of the Arc of Macomb County, who attended a rally in front of U.S. Rep. John James’ office organized by SEIU Healthcare union, Michigan AFL-CIO, Detroit Action and Michigan United calling for the Republican Congressman from Shelby Township to reject any Medicaid cuts. “I’m worried because all of the programs under attack right now are social service programs.”

“It’s hard to advocate for something after it happens,” added Christy Jane Courtney, director of operations at Arc, who joined Lepine at the protest in Warren and rally at the nation’s capital. “So, the time for advocacy is before the cuts happen.”

Medicaid lifelines

The Arc of Macomb County is a nonprofit that is dedicated to providing people with intellectual and developmental disabilities (IDD) advocacy and services that provide them with the opportunity to choose where and how they learn, live, and work throughout their lifetime in the community they share. A majority of this support comes from Medicaid.

It provides health insurance and access to long term care to more than one in five people in the United States including:

• 44% of adults with disabilities under the age of 65

• 1 in 2 children with disabilities or medically complex conditions

• 6.4 million adults who receive long term support and services

This list compiled by the Arc shows the scope of services that are provided to people with disabilities throughout their life:

• Early childhood — Medicaid is the number one funder of early intervention programs that help infants and toddlers with disabilities get the support they need for a healthy start including speech, physical and occupational therapy and more.

• School — Medicaid pays for school-based physical, mental and behavioral health care that’s needed in order for a child with disabilities to learn and thrive.

• Health — The primary source of public health insurance for people with disabilities is Medicaid.

• Daily life — Medicaid is the main source of long term support and services (LTSS), which assist people with disabilities including everything from eating and taking medications to dressing and getting in and out of bed.

• Community — Medicaid funding for LTSS enables people with disabilities to live in home and community settings rather than institutions. Home and community based services (HCBS) provide 4.5 million people with disabilities the support they need to live independently and to contribute to the community where they choose to live. These services include in-home health care, adult day programs, transportation and home maintenance.

• Work — These HCBS services funded by Medicaid also include job training, placement and personal support that enables people with disabilities to find and maintain employment. It also covers the cost of assistive technology and equipment such as mobility devices and communication aids that help people with disabilities work.

“Cuts would mean people would not have the support they need to stay healthy,” Lepine said.

Courtney concurred.

“We have people who can’t transfer out of their wheelchair without support and we have people who cannot feed themselves. We employ about 40 direct support professionals who provide these services to people with disabilities and if these people lose their jobs these people could die.”

Lepine said she has heard the concern over fraud abuse within the Medicaid system.

“But you don’t need to use a sledgehammer to stop it,” Lepine said, noting it’s very hard for people to get qualified for Medicaid services, which is why she can’t wrap her head around the idea of someone taking advantage of it. “There’s a lot of layers of protection to prevent waste.”

Community health

Among the roundtable discussions that have been held since the budget plan was announced was a virtual meeting on March 27 attended by officials representing 24% of Macomb County’s population, or the 233,000 people who rely on Medicaid.

This includes people with disabilities but also veterans, seniors, children and low-income families.

“Macomb County’s efforts on this issue center around urging policymakers to recognize the human impact behind proposed budget cuts. While financial considerations are important, reducing funding for vital health programs can seriously affect real people, especially vulnerable populations,” said Andrew Cox, director and health officer for Macomb County Health Department, who was present for the roundtable discussion. “These cuts could limit access to care, increase health disparities and worsen outcomes for those who rely on public health services.”

Cox said the call to action is clear.

“Policy decisions must prioritize people over profit and protect essential resources that support community health and well-being,” he said.

What has been approved is a budget plan that lays the groundwork for a harmful tax and budget bill that would seek to cut or cap essential social service programs funded by Medicaid but also services provided by Medicare and the Supplemental Nutrition Assistance Program (SNAP), which are a crucial lifeline for many of its recipients.

In some cases as Lepine and Courtney point out it’s a matter of life and death. In other cases lost services would result in delayed treatments, skipped medications and postponed preventative care leading to more emergency room visits and higher overall healthcare costs for everyone.

Then there’s the health care providers.

Cox said cuts to Medicaid would also severely impact these businesses who rely on Medicaid reimbursements, potentially causing staff layoffs, program closures and reduced capacity to care for vulnerable populations.

In the end it would hurt both patient care and the local economy.

“Additionally, the broader public health consequences would be significant including increased rates of preventable diseases, mental health crises and substance use disorders, which would place added strain on emergency services and threaten community health as a whole,” said Cox.

“We need a better path forward,” said Monique Stanton, president and CEO of the Michigan League for Public Policy and among the speakers attending the March roundtable discussion. “Members of Congress must consider the people who elected them and the commitments they made to ease their financial burdens. A budget plan that seeks to harm families with low incomes in order to save those at the very top is not only nonsensical and irresponsible but flat out cruel.”

While the budget reconciliation bill itself does not mandate any cuts to Medicaid it does direct the House Energy and Commerce Committee with jurisdiction over Medicaid, Medicare and the Children’s Health Insurance Program to reduce the federal deficit by $880 million over 10 years.

“This potentially puts Medicaid in the crosshairs,” according to a report from The Association Press. “One way to cut the cost of this program is to reduce the benefits to enrollees, something President Donald Trump and GOP leaders in Congress have vowed not to do.”

James did not return inquiries from The Macomb Daily regarding the possible cuts but has said in previous Twitter posts that Republicans will protect Medicaid for those who are in need of the program’s benefits.

Potential cuts were included in the 2026 budget framework narrowly approved earlier this month by House Republicans, according to the Hill. The Associated Press reports federal lawmakers will work over the coming weeks and months to turn the framework into a budget bill for final approval. All Michigan House Republicans — including James and Lisa McClain, whose district extends from northern Macomb and Oakland counties into the Thumb — voted for the budget.

A health care professional from Macomb County, who attended the rally in Washington, D.C. also said he spoke with legislators on both sides of the issue during his time on Capital Hill.

“I reached out to both Democrats and Republicans. I said, ‘Hey, I’m concerned about the Medicaid cuts,’ and he said, ‘Where are you hearing that? That’s not what we’re doing.’ All of the Republicans I talked to said they are only cutting Medicaid waste, fraud and abuse,” said the health care professional, who asked to remain anonymous because of his position. “When I talked to the Democrats they said the only way to meet that $880 million goal is to impact Medicaid.”

He said it’s a terrible situation — not knowing who to believe.

Among those concerned for the welfare of women and children is Sharman Davenport.

“If cuts to Medicaid, Medicare and SNAP occur, the survivors we serve will be significantly impacted,” said the president and CEO of Turning Point, a nonprofit agency that provides services to survivors of domestic violence and human trafficking including advocacy, counseling, emergency shelter and programs for transitional and rapid housing. “Those cuts would limit their access to essential mental and physical health care services, push survivors and their children back into food insecurity and potentially delay or deny lifesaving treatments. For many survivors rebuilding their lives after trauma, social support programs are critical to helping them stabilize, heal and move towards safety.”

Davenport said Turning Point is already coordinating with other community resources to ensure that they are prepared to fill any gaps that may arise but they cannot do so without adequate resources.

“Nonprofits like ours continue to advocate for survivors in our community even as the federal funding streams we rely on face uncertainty,” Davenport said, adding this is not just a policy issue.

“It is a matter of survival, safety, dignity and humanity,” she said. “If we care about building a healthier and safer community we must protect the programs that enable vulnerable individuals and families to regain stability.”

Cox said his office has not been inundated with calls from Medicaid recipients.

However, many who are in the know have been attending rallies and protests.

One mom who took part in a protest in Warren told The Macomb Daily her 3-year-old disabled son requires a prescription formula that she said would cost $400 a month out of pocket if Medicaid was not available to her.

Another protester said Medicaid provided long-term nursing home care for his mother who died a couple of years ago.

Cox said the most important thing for Medicaid recipients to know is that no immediate changes have been made to their coverage and that they should continue using their benefits as usual.

“However, with potential funding cuts being discussed it’s crucial to stay informed,” he said. “Respond to renewal or eligibility notices and reach out for help if they have any questions or concerns. Being proactive ensures they don’t experience any gaps in care or coverage.”