Medicaid, Pollution, and Policy Failures — An Overlooked Cycle

For years, conservatives have pushed for cuts to Medicaid under the guise of fiscal responsibility. They tell us that slashing these funds will reduce government spending, ease the tax burden, and promote self-sufficiency. But let’s be clear — cutting Medicaid isn’t just a short-sighted budget decision. It’s an attack on public health, an environmental justice disaster, and ultimately, an economic blunder.

Low-income communities, particularly Black, Hispanic, and Indigenous families, disproportionately suffer from environmental hazards — polluted air, contaminated water, toxic waste sites — from a dark history of colonization and redlining. These aren’t abstract threats; they are daily realities. Medicaid is one of the few tools these communities have to access healthcare for the diseases caused by environmental injustices. If we allow cuts to Medicaid, we are sentencing people to worsening health crises, higher costs down the line, and an ever-deepening racial health gap.

The Hidden Costs of Cutting Medicaid

Let’s talk dollars and sense. Proponents of Medicaid cuts claim that reducing government spending will balance the budget. What they don’t tell you is that cutting Medicaid doesn’t eliminate healthcare costs — it simply shifts them.

When people lose Medicaid coverage, they don’t stop getting sick. They don’t suddenly stop having asthma attacks from air pollution or developing lead poisoning from outdated water infrastructure. Instead, they delay treatment, leading to more severe and costly conditions that land them in emergency rooms. States that expanded Medicaid saw a 6% reduction in unpaid hospital bills, meaning fewer people relied on emergency care without coverage (Camilleri, 2017).

Meanwhile, states that refused expansion saw higher uncompensated care costs, which ultimately fall on hospitals and taxpayers. Beyond individual health costs, cutting Medicaid increases economic strain on local economies. When people can’t afford to manage chronic conditions, they miss more work, decreasing workforce productivity. A study found that Medicaid expansion actually led to greater workforce participation among low-income adults, debunking the myth that Medicaid promotes dependency.

Environmental Injustice and the Medicaid Safety Net

The intersection of Medicaid and environmental justice is undeniable. Low-income communities of color are more likely to live near highways, industrial plants, and toxic waste sites — areas with disproportionately high rates of asthma, cancer, and other pollution-related diseases. These are the same communities that rely on Medicaid to treat the very illnesses caused by environmental racism.

Cutting Medicaid means fewer asthma medications for children in the Bronx, where hospitalization rates are eight times higher than the national average. It means fewer cancer screenings for residents in Louisiana’s “Cancer Alley,” where Black communities are exposed to some of the highest levels of industrial pollution in the country. It means fewer resources for Flint, Michigan, where a lead contamination crisis poisoned thousands of children — many of whom rely on Medicaid for long-term developmental support. This is a matter of racial justice. One in three Black Americans and nearly one in three Hispanic Americans rely on Medicaid. Cuts to this program disproportionately harm communities already battling the health impacts of systemic pollution.

Connecting the Dots: Medicaid and EPA Cuts Go Hand in Hand

If cutting Medicaid is an attack on environmental justice, then cutting the Environmental Protection Agency (EPA) is an outright war. The same lawmakers who argue that Medicaid is “too expensive” are the ones slashing EPA budgets, gutting enforcement of pollution laws, and rolling back regulations that protect our air and water.

Take, for example, the repeated attempts to weaken the Clean Air Act. Research has shown that reducing air pollution saves thousands of lives each year. But when the EPA cuts enforcement and slashes funding for pollution monitoring, air quality worsens — hitting marginalized communities first and hardest. And guess who foots the bill for the health fallout? Medicaid.

It’s a vicious cycle: Lawmakers weaken pollution protections, communities get sicker, Medicaid costs rise, and then they turn around and claim Medicaid is too expensive. Instead of addressing the root causes of health disparities — pollution, environmental degradation, corporate negligence — they cut the very programs that help people survive them.

The Real Fiscal Responsibility

If we’re serious about cutting costs, we should be expanding Medicaid, not gutting it. We should be increasing EPA funding, not rolling it back. Investing in preventive healthcare and environmental protections saves money in the long run. Every dollar spent on environmental health interventions yields an average return of $17 in health benefits.

When people have access to healthcare, they’re more productive, more resilient, less reliant on emergency services, and less likely to suffer long-term economic consequences from preventable diseases. When we enforce environmental regulations, we reduce the burden of pollution-related illnesses, lowering healthcare costs for everyone.

The real question isn’t whether we can afford Medicaid. It’s whether we can afford the alternative — rising healthcare costs, worsening racial disparities, and a public health crisis spiraling out of control.

What’s next?

Let’s call these Medicaid cuts what they really are: a moral failure, an economic miscalculation, and an environmental justice catastrophe. If we care about fiscal responsibility, racial equity, and public health, we should be fighting to expand Medicaid, not defund it. We cannot afford to let Republicans’ political games put lives at risk. The cost of inaction is far greater than the cost of care.