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Guest Commentary

Without Medicaid, How Many Rural Americans Will Die?

By Archbishop Marcia Dinkins, PhD Guest Commentator

The attacks on Medicaid aren’t just policy choices — they’re signing people’s death certificates before they ever see a physician.

November 20, 2025 3 min read Free to read

This year, my adult daughter in rural Michigan was hospitalized multiple times with a raging infection of her pancreas, spleen, and gallbladder. Surgery saved my daughter’s life. And that surgery was possible because of Medicaid.

As a parent and grandparent, I do everything possible to protect the health and safety of my loved ones — just like you do. That doesn’t just mean taking care of things around the house or getting them to the doctor — it can also mean fighting against the policies that make people sick or deny them care.

When my kids were young, poor air quality and environmental hazards caused our family physical, mental, and financial anguish. Now my three adult children have serious medical issues, including seizures and pulmonary embolisms.

Millions of other Americans have health issues like these — and their lives will be at risk if they lose Medicaid coverage.

That’s what drove me to found the Black Appalachian Coalition to close race and gender health disparities. Our work focuses on communities throughout Appalachia, including in Kentucky, Ohio, Maryland, Pennsylvania, Tennessee, New York, and West Virginia.

Through my work in the Bluegrass region of Kentucky, I met Linda Brown — a staunch advocate for affordable health care, driven by personal experience.

Brown once had a medical emergency

and spent nine days in the hospital. “I

didn’t know if I would live, yet I never

had to wonder how I would pay. Medicaid

and the Affordable Care Act saved my

life,” she said. Affordable health care “let

me focus on healing, on breathing, on

being a mother, instead of drowning in

fear of medical bills.”

As Brown recovered, she felt hopeful. She could take care of herself and her son, and help others in the community. Now she’s a Black Appalachian Coalition trainer and supports people to share their story and point us towards solutions.

Now’s the time to start sharing stories like hers. Ten million Americans will lose health care coverage because of the federal cuts to Medicaid. Coupled with cuts to Affordable Care Act subsidies — the still unresolved sticking point of the recent government shutdown — up to 17 million Americans could lose care overall.

Without medical coverage and funding for health care institutions, people will lose access to maternal health care, mental health and drug treatment, and preventative and primary care.

Rural areas already experience slow care — but with the cuts, we will have no care. That’s because health care providers will cut services or shut down — especially in rural areas and low-income communities where hospitals are more dependent on patients with Medicaid coverage.

That will impact care even for people with traditional private insurance. We’ll see an increase in emergency room visits, and the burden of the costs will be shifted to already stretched communities.

The attacks on Medicaid aren’t just policy choices — they’re signing people’s death certificates before they ever see a physician. They’re denying people like my daughter — or someone you love — access to the treatments, prescriptions, and care that could save their lives.

With this experience in mind, I worked with 40 organizations to produce the Rural Policy Action Report, which provides a federal policy agenda — including on health care — to improve rural people’s lives.

I know I speak for my rural neighbors

when I say we’re demanding that

Congress reverse its cuts to Medicaid and

the Affordable Care Act, expand health

care coverage, lower prescription drug

prices, and ensure access to care that all

of us deserve.

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