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To the Editor:

Recently, the U.S. House of Representatives narrowly approved a controversial tax and spending bill (H.R. 1) backed by President Trump that includes deep cuts to the Medicaid and Medicare programs in order to offset $1.5 trillion in tax breaks that disproportionately benefit the wealthy. The vote was 215 to 214 along mostly party lines. All Democrats opposed the 1,116-page measure.

Rep. Greg Murphy (R-03-NC), Dare County’s congressional representative, joined his Republican colleagues in support of the legislation, applauding its passage in a May 22 press release available on his website at https://murphy.house.gov. He is up for reelection next year.

The bill now heads to the U.S. Senate where changes are likely. Some conservative Senators want deeper federal savings whereas others are voicing objections to the current level of Medicaid reductions in the House version of the bill believing they go too far and would harm low-income Americans. Final passage of the bill is slated for early July.

Take action. We are at a crucial point in the negotiations process between the two chambers. Please contact your U.S. Senators, Thom Tillis (up for reelection in 2026) and Ted Budd, at 202-224-3121, now in opposition to this legislation. Tell them to reject harmful cuts to the Medicaid and Medicare programs!

House Republicans maintain the bill only targets waste, fraud and abuse. However, the nearly $700 billion in Medicaid reductions would reduce the number of people with health care by 8.6 million over 10 years, according to preliminary figures from the nonpartisan Congressional Budget Office (CBO). In North Carolina alone some 260,000 people could lose their coverage if this bill is enacted into law, per estimates from the Kaiser Family Foundation. With tax credits from the Affordable Care Act set to expire, the number of North Carolinians who could lose health care coverage rises to more than 470,000.

Moreover, CBO projects that H.R. 1 would add about $3.8 trillion to the national debt over 10 years. Because the bill raises the deficit, it would trigger across the board cuts of nearly $500 billion in Medicare over 10 years, through a process known as “sequestration,” unless Congress acts to prevent them.

Medicaid is a state-federal program that provides health coverage to millions of eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities. The provisions in the House bill would for the first time impose strict national work requirements on certain Medicaid beneficiaries, beginning in December 2026; require states to impose cost sharing of up to $35 per service on those with incomes 100% to 138% of the federal poverty level; require states to confirm recipients’ eligibility for Medicaid at least every six months; and freeze provider taxes at current levels, among other provisions.

Not only are Medicaid beneficiaries affected by the spending reductions in the legislation,  rural health care providers will also be impacted. Medicaid funding is critical for sustaining rural healthcare systems, including hospitals, clinics, and community health centers. A strong relationship exists between Medicaid coverage levels and the financial viability of rural hospitals and providers. Medicaid expansion, as in North Carolina, has been associated with improved hospital financial performance and lower likelihood of closure in rural markets. Just imagine what healthcare would look like in Dare County if our local hospital were forced to close because of this legislation.

If you share my concerns and the concerns of many citizens across the state and across the country about the harmful cuts in this bill, please contact your Senators today. They need to hear from the public now.

Laura Allendorf

Manteo

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