The United States is no longer a member of the World Health Organization, but if we were, many of our health care leaders and policymakers would be working on one of the 2030 Sustainable Development Goals of global universal health care — meaning “all people have access to the full range of quality health services they need, when and where they need them, without financial hardship.”

In the United States, there is a long way to go, and Congress is proposing to make devastating changes to one of the largest programs that allows millions of people in our country access to care by making drastic cuts to Medicaid.

Medicaid, or MaineCare as it’s known here, provides health coverage for more than 400,000 Mainers, including 35% of our children and 53.9% of our kids under age 6. The state-federal partnership pays for 39% of births and provides care for 65% of nursing home residents in Maine. It is the largest source of federal funding for mental health services for children and adolescents.

Hospitals and health clinics across the state, especially our most rural facilities, rely on these funds to keep their doors open. In short, it is a critical piece of our health care infrastructure. If the federal government cuts its share of MaineCare funding, as Congress has proposed, our state government will have many difficult competing priorities to weigh to address the loss in funding. That spells trouble not just for health care but for other priorities, such as education, housing and transportation.

The federal proposal comes at a time when Maine’s health care system is already on shaky ground. Northern Light Inland Hospital in Waterville closed in June, citing financial challenges. MaineGeneral Medical Center in Augusta is laying off 100 employees, pointing to delayed MaineCare reimbursements as a key factor. In Aroostook County, Houlton Regional Hospital is shuttering its labor and delivery services, leaving fewer options in the state’s rural northern tip.

Maternity wards are also closing in Belfast’s MaineHealth Waldo Hospital and Bar Harbor’s Mount Desert Island Hospital. Most recently, MaineGeneral Health announced the closing of the Edmund Ervin Pediatric Center in Augusta, redistributing some of the services and eliminating others — notably psychological assessments for children and rapid evaluation of youth entering foster care. Cutting federal Medicaid dollars will only exacerbate this trend.

Maine’s youth are caught up in a mental health emergency and unfortunately there is a dearth of services available to support them. The situation had become so dire that in November of 2024 the state resolved a suit with the Department of Justice because of its failure to provide timely access to services for high-risk youth in their community. Behavioral health services are already reimbursed at lower rates and further cuts to Medicaid will not enhance the provision of community-based services nor attract appropriately trained clinicians into this demanding work.

Our state leaders recognize this. In fact, a $118 million shortfall in the state’s share of MaineCare funding monopolized much of the budget debate in this year’s state legislative session. The Democratic majority filled that gap in the budget approved in March, but hospitals and clinics will have to wait months for their reimbursements. Given the uncertain situation in Washington, state lawmakers only agreed to address the deficit for one year.

Proponents are trying to disguise Medicaid cuts as eliminating “waste, fraud and abuse,” but cutting Medicaid would do nothing to improve program integrity. Proposals would increase administrative burdens and decrease access to care for many. Since when did providing care for children, those with disabilities and low-income elderly constitute waste.

We encourage our congressional delegation to keep fighting against these harmful cuts. The same budget plan that proposes to make deep and damaging cuts to Medicaid would provide trillions in tax cuts for the wealthiest Americans. That money is better spent ensuring Mainers have access to needed health care!