The Pennsylvania Independent: ‘Quickly unfolding healthcare catastrophe’: What Medicaid cuts are doing to Pennsylvania
State Rep. Arvind Venkat, an emergency physician who practices at McCandless Neighborhood Hospital in Pittsburgh, well remembers the trials of being a doctor before the Affordable Care Act.
In those days, 20% of his patients had no health insurance, and people would turn to the emergency room for primary care. Patients would arrive with medical issues, such as breast cancer, that had long gone untreated, when it was too late to save their lives.
“I’ve personally seen patients die as a result of that, and, unfortunately, again, for me and my colleagues in emergency medicine, we are going to see that again — and we already are,” Venkat, a Democratic lawmaker whose district covers part of Allegheny County, said during a May 1 press call organized by Defend America Action. The group launched last year to challenge abuses of power at the federal level.
Once the Affordable Care Act passed in 2010, his patients’ health improved, Venkat said. More people were insured and could pay for primary care, and new healthcare facilities opened to serve them. At the start of 2025, a record-breaking number of people purchased ACA marketplace plans, both nationwide and in Pennsylvania.
Now, Venkat said, the state and the country are reverting to a health landscape in which people increasingly cannot afford coverage and are unable to pay for the care they need, after congressional Republicans last year made sweeping budget cuts to Medicaid in their One Big Beautiful Bill Act, signed into law by President Donald Trump in 2025, and refused to extend Affordable Care Act tax credits. Those credits had helped tens of millions of Americans purchase health insurance through their state marketplaces.
During the press call and in interviews following it, elected officials, healthcare providers and healthcare experts described the mounting challenges in the state, including the likelihood that hundreds of thousands of Pennsylvanians could lose health insurance at the start of next year because of new Medicaid work requirements in the budget law. They warned of the closure of hospitals that heavily rely on Medicaid funding, and said that state governments would be forced to make difficult financial decisions because they’ll be unable to offset the loss of federal Medicaid funds.
“Over the course of my lifetime, we’ve been on a trend where we have been slowly and steadily expanding access to healthcare and getting more and more people into our healthcare system,” Michael Berman, the president of Protect Our Care Pennsylvania, a progressive healthcare advocacy group, told the Pennsylvania Independent. “I think this is the first time in history that I can remember where we’ve seen our government trying to kick people out of the healthcare system systematically and trying to exclude more people from having access to healthcare.”
About 130,000 people in the state have dropped their coverage this year, according to Pennie, the commonwealth’s health insurance marketplace, following the lapse of the ACA tax credits and the surge in health insurance premium costs.
Come Jan. 1, when new Medicaid work requirements go into effect, another 300,000 Pennsylvanians could lose their health coverage, according to Gov. Josh Shapiro’s administration. Those individuals will primarily lose their health insurance due to bureaucratic red tape, not because they don’t meet requirements to enroll in Medicaid, according to Venkat and others on the press call.
As part of the new requirements, Medicaid enrollees will have to more frequently submit paperwork to prove they are eligible for benefits, burdening low-income families who often either don’t know about the new changes or don’t have the time and resources to keep up with the added requirements, according to researchers.
“It’s not just the people who are not eligible who get caught up in it,” Chiquita Brooks-LaSure, who served as the administrator of the Centers for Medicare and Medicaid Services from 2021 to 2025 under President Joe Biden, said during the press call. “It is the person with disabilities who has to fill out [paperwork] every couple of months to prove that they have the same disability. It is people who are struggling and juggling jobs to remember the paperwork.”
Those individuals without health insurance will then likely turn to emergency departments for care that they should have received through their primary care provider, Venkat said, and more people will die because they couldn’t access preventive care.
“My message today is that we are in a very quickly unfolding healthcare catastrophe in this country, and that people are unfortunately going to become very sick or die as a result of that,” Venkat said. “And it is because of deliberate policy choices by Donald Trump and his administration to rip healthcare away from millions of Americans in order to give tax cuts to millionaires and billionaires, and there’s no reason to sugarcoat this.”
As more uninsured patients turn to emergency rooms for care that is often too expensive for them to cover out of pocket, hospitals in Pennsylvania and across the country will face further financial challenges covering those increased costs at a time when they’re already operating at the margins, or in the red, those on the press call said.
The Pennsylvania Health Access Network in 2025 identified 47 hospitals in Pennsylvania that faced closure following the Medicaid cuts. One of those hospitals, Bradford Regional Medical Center, will cease being a hospital on May 17; the facility will continue to provide outpatient services.
Once a hospital closes, the patients that would have gone to that facility then have to go elsewhere, and the institutions they turn to will likely take a financial hit as they absorb new uninsured patients, Venkat and Berman said.
“As those rural providers shut down, more and more folks would be going into the suburban and urban providers and overwhelming the care that is there,” Berman told the Pennsylvania Independent.
While residents lose their insurance, hospitals shutter and people die because they can’t afford medical care, the state government can’t afford to plug the financial hole left by the federal cuts, Venkat said. Pennsylvania could see as much as $20 billion in cuts to Medicaid over the next decade, Department of Human Services Secretary Valerie Arkoosh testified during a February budget hearing.
“This bill, the federal reconciliation bill, the One Big Beautiful Bill Act — which is a terrible title — was basically designed to cost a lot of money out of the healthcare system, rip away health insurance from people, because that’s the only way that the savings are realized, even though they say, Oh, no one who is supposed to be getting healthcare will lose it, which is BS,” Venkat told the Pennsylvania Independent. “As a result, we’re going to see a huge gap at the state level. The federal government has left us holding the bag, and we really don’t have a good way to fill it.”
As a result, states could be forced to make cuts to healthcare programs, Brooks-LaSure said.
“States are going to have to make some difficult choices, and a lot of them will be around things like home- and community-based services, things for children with disabilities,” she said. “People are so reliant on these services.”
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