Congress Cuts Medicaid to Fund ICE: How H.R. 1 Harms Communities
Earlier this summer, Congress approved its most harmful budget in a generation. H.R. 1 or the “One Big Beautiful Bill Act” made the biggest cut to Medicaid since it was created in the 1960s and funneled that money to fund President Donald Trump’s racist anti-immigration agenda.
Instead of strengthening Medicaid, Congress took an axe to it. Instead of reining in Immigration and Customs Enforcement (ICE) abuses, Congress gave the agency billions more to terrorize our communities and detain families.
As Congress returns to their home states to meet with constituents and conduct in-district business during the August recess, the preceding six months must be top of mind. Representatives are facing the judgement of their constituents and must answer for their actions: did they capitulate to the Trump administration, or did they fight back? In turn, the American people must make clear that lawmakers' attacks on our health care and civil liberties are unacceptable.
Below, we outline what you need to know about this year's devastating federal budget bill — and how we can fight against this attack.
Cuts to Medicaid Threaten Our Lives
Medicaid is a critical resource across the country, especially for children and people with disabilities. Politicians' vote to cut Medicaid, a program that provides coverage for an estimated 70 million patients, means that in every single state and congressional district, people are closer to rationing medication, missing essential medical treatments, and losing access to the care they need.
Unsurprisingly, the most vulnerable among us will feel the brunt, including 12 million people with disabilities who rely on Medicaid. Medicaid coverage is a lynchpin to ensure people can exercise their right to live in their own homes, rather than dehumanizing institutions. Denying these supports and care forces people into institutions, stripping them of the liberty and autonomy our Constitution protects.
Martha Haythorn, a 25-year-old woman with Down syndrome from Georgia, is among the people whose freedom is endangered by cuts to Medicaid. She shared with the PBS Newshour that Medicaid helps her access her community. “I deserve to be there,” she said. “Without these benefits, I can't do that. Is it really worth taking away someone's benefit, someone's life, someone's accommodation?”
Courtney Leader of Missouri told CNN that she wrote to her senator, Josh Hawley, to share how Medicaid has helped her keep caring for her daughter, who has brain damage and cerebral palsy, at home. “Without Medicaid, we would lose everything – our home, our vehicles and, eventually, our daughter,” she wrote. Sen. Hawley was one of the 50 Senators who voted to cut Medicaid.
Medicaid also covers care for the two-thirds of people living in nursing facilities, and for the nearly 14 million people with mental health conditions or substance use disorders. Millions more could lose insurance coverage because of unclear rules and red tape created by new paperwork requirements and related reporting systems for Medicaid coverage.
The impact of H.R. 1 will be felt by people across the country, regardless of their incomes, for decades. Medicaid and other federal funds limited in H.R. 1 keep rural hospitals open, support medical training and clinical research, and ensure that people can get the care they need throughout their lifetimes. Finally, Congress’s cuts reduce the federal share of Medicaid funding, forcing states to cut services to meet budget shortfalls and further compounding the harm to our communities.
Access to health care is essential to our bodily autonomy and our freedom. Without these essential programs, our right to live fulfilled lives and control our futures will be greatly diminished.
Additional Risk to Reproductive Freedom
H.R. 1 also carries out one of the most dangerous goals of Project 2025: “defunding” Planned Parenthood by banning Medicaid patients from using their insurance there. This ban not only means that Medicaid patients can’t use their insurance for birth control, cancer screenings, STI testing, and other preventive care at Planned Parenthood — it also puts access to abortion access at risk even in states where abortion is legal.
A federal court blocked this “defunding” so Medicaid patients can continue to use their insurance for care at Planned Parenthood for now, but the legal battle will surely continue. If Planned Parenthood is truly “defunded”, hundreds of health centers would close, including a quarter of the country’s remaining abortion providers. Patients already struggle to access abortion, and, without Planned Parenthood, that could get even worse.
The ability to access timely reproductive health care will also worsen. There simply are not enough health care providers to serve the millions of patients seen by Planned Parenthood. The Trump administration has already attacked other essential reproductive health providers by withholding funds in the Title X family planning program, leaving patients with even fewer options for care. As a result, patients face longer wait times, travel, and delays in care.
For patients like Jamie Benner-Clemons, "defunding” Planned Parenthood could mean the difference between life and death. Benner-Clemons went to Planned Parenthood when she did not have health insurance. The cancer screening she received caught her breast cancer before it was too late. “The urgency of the health center staff saved my life,” she shared with Planned Parenthood.
Cuts to Medicaid will further endanger pregnant people nationwide. Medicaid covers 40 percent of births in the U.S. Without this coverage during pregnancy, many women would not get essential prenatal care. In rural areas, especially, these cuts will make pregnancy more dangerous. Dr. John Cullen, a family physician in Valdez, Alaska, a remote city of about 4,000 people, told The 19th, that “already we’re seeing [pregnancy care] deserts that are increasing in size, and after the passage of this bill those are going to be markedly worse — where people are going to have to drive hundreds of miles before they can get prenatal care, much less delivery.”
Cutting Health Care to Fund Detention Camps and Deportations
The politicians who supported H.R. 1 took health care away from millions, while giving $170 billion in taxpayer dollars to an immigration police force larger than most of the world’s militaries and detention camps that could, over time, hold 750,000 children, immigrants with legal status, and other long-time residents from our communities. This sends a clear message that, for politicians, care for people with disabilities is out, while $50,000 bonuses for new ICE agents are in.
This budget will reshape, perhaps permanently, immigration enforcement and detention in the U.S., funneling $45 billion into private prison companies and mass tent cities where few people can find a lawyer. This administration has already cut funding for services for unaccompanied children.
At a time when there are increased deaths in custody and appalling conditions at some of the new immigration camps, ICE is already cashing in on its new allowance and is set to expand detention to almost 110,000 beds in the next six months. This is dangerous and unprecedented. We need members of Congress to bring oversight to these expanding sites.
Meanwhile, in multiplying the number of immigration agents on our streets, H.R. 1 is funding a police state where parents—including U.S. citizens— who take their kids to school or the hospital may be asked to “show their papers” by masked agents or even be detained in private prisons and tent cities without counsel or due process.
We’ve already seen how the Trump administration’s immigration machine is terrorizing our communities. Masked ICE agents across the country have refused to provide identification during arrests, where they have forcibly taken people away in unmarked vehicles and left families with no information on where their loved ones are or whose custody they’ve been taken into. Already, there have been numerous cases of people impersonating ICE officers to threaten and harm people who are immigrants. As these raids and arrests grow more common and more aggressive, it is essential that immigration agents can be identified as such, which is why the VISIBLE Act — a commonsense transparency measure that requires DHS and ICE agents to wear visible identification — was just introduced in the Senate. As ICE agents multiply around the country with this new budget windfall, Congress must pass this bill immediately to protect community safety.
Americans Will Hold Congress Accountable
The politicians who voted for this budget monstrosity chose to sacrifice their constituents’ health, rights, and dignity. The American people will hold them accountable.
This August, the ACLU and our partners hosted events across the country to call out the politicians who supported this reckless attack on our health care, our civil liberties, and our very ability to survive. ACLU People Power volunteers mobilized their communities to town halls and confronted their Congress members about their decisions.
In Colorado, 50 constituents walked into Representative Jeff Hurd’s district lobby, holding signs and leaving hand-written notes at his office.
In Arizona, constituents attended a town hall hosted by the ACLU of Arizona in Representative David Schweikert’s district. Speakers and constituents alike focused on the $170 billion turbocharge of the president’s deportation machine, which has been fraught with abuses of power by the federal government and was paid for through cuts to Medicaid for people with disabilities.
Recent public polling demonstrates how extremely unpopular this bill is with Americans across the country. Two-thirds of the American public (64 percent) opposes H.R. 1. We must make this opposition clear to Congress by showing up at public events, calling, writing, and visiting congressional offices to let politicians know how unhappy constituents are, and how much H.R. 1 hurts our communities, our rights, and our society.
Republican leadership in Congress are preparing to create a multi-billion dollar slush fund for the Trump administration to use as their budget, as well as attach countless policy riders that risk our civil rights and liberties. We have the opportunity to tell our representatives to vote no on any of these poison pill spending bills that restrict our rights and we must. Join People Power today to stay informed about what Congress is up to and how you can get involved to protect all of our rights. Together we will fight and win.
Published August 20, 2025 at 11:51PM
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