By Suzanne Wikle

The 119th Congress has begun debating legislation to renew the first Trump Administration’s tax package from 2017 that many are framing as a discussion about tax cuts. However, the debate is really about whether making billionaires and large corporations wealthier is more important than health care and food for millions of Americans. That’s because Republicans have clearly stated they want to cut Medicaid and food assistance so they can make the super-rich even richer.

Medicaid provides health insurance to 79 million Americans, primarily children, seniors, people with disabilities, and pregnant women. Republicans have proposed several changes to Medicaid as a way to “pay for” tax cuts, totaling one-third of all federal Medicaid spending over the next decade.

Any change to Medicaid that offsets or “pays for” tax cuts is a cut to Medicaid, and cutting Medicaid will set off a cascade of negative effects. Millions of people will lose their health insurance, which means worse health outcomes that could have been prevented, premature death, and increased medical debt and bankruptcies. As Medicaid is the largest payer of mental health and substance use services, many individuals’ mental health concerns will go untreated or become more severe. For hospitals and other health care providers, cuts to Medicaid directly translate to more uncompensated care, as well as the likely closure of rural hospitals and nursing homes. The proposed cuts will also create a major budget hole for state budgets. On average, federal Medicaid dollars account for 57 percent of total federal funds spent by states. Federal cuts to Medicaid will force states to kick people off Medicaid and likely cut other parts of their budgets.

Congress has also proposed slashing nutrition assistance as part of the package to provide wealthy Americans with more tax cuts. By reversing recent policies that increased nutrition benefits to account for higher food costs that all Americans are facing and creating more red tape and eligibility limitations, policymakers would ultimately take food off the table of families, people with disabilities, and seniors, while also draining money out of local economies.

An honest debate about taxes would not suggest wholesale and disastrous changes to people’s health care and nutrition access as a means of making billionaires like Elon Musk even wealthier.

Our tax system should help families and children, not the wealthy and powerful. Tax policy can have a huge role in decreasing poverty, as we saw during the COVID-19 pandemic when the expanded Child Tax Credit (CTC) slashed childhood poverty in half. Congress should make these changes to the CTC permanent. In addition, lawmakers should establish a renter’s tax credit to support Americans priced out of homeownership. Finally, policymakers should expand the Earned Income Tax Credit to invest in workers of all ages without dependent children. These tax policies have the potential to affect the lives of millions of Americans in a positive way, rather than just a few at the wealthiest end of the economic spectrum.

As advocates, we’ll continue to voice the truth: the proposals by Republican members of Congress will make billionaires wealthier by taking away health care and nutrition support from millions of Americans, including constituents in their districts. There is no middle ground if it includes cuts to people’s basic human rights of health care and food.