A senior woman with cancer (Photo Credit: FatCamera, Getty Images Signature).
What if lawmakers quietly stripped health care from our elders and our children—and we only found out when it was too late?
That’s exactly what’s happening now with H.R.1, the Big Beautiful Bill Act. Pitched as a cost-saving measure, the bill proposes turning Medicaid into block grants and capping per-person spending—effectively ending the program as we know it.
On paper, it’s about “fiscal discipline.” But in reality, it’s a quiet gutting of America’s largest safety net. And Black families will be hit hardest.
Black seniors depend on Medicaid at far higher rates than their white counterparts. According to a 2023 analysis by Protect Our Care, more than one-third of older Black adults rely on Medicaid for essential health coverage, compared to just over one-quarter of older adults of color overall.
The share is significantly lower among white seniors. For Black elders living with chronic illnesses—especially those who need home health aides or long-term care—Medicaid is often the only lifeline.
But when federal funding is slashed, states are forced to ration care. That means fewer doctor visits, delayed cancer treatments or lost access to life-saving prescriptions. Imagine telling your 74-year-old grandmother that her chemotherapy no longer qualifies for coverage.
And the impact on children is just as devastating. More than 50% of Black children in America depend on Medicaid or the Children’s Health Insurance Program (CHIP) for their health care. These programs encompass a wide range of services, including pediatric checkups and vaccinations, emergency room visits and asthma care.
If CHIP gets rolled back, as H.R.1 proposes—with stricter eligibility, new waiting periods and reduced reimbursement rates for providers—Black children will lose access to the very services meant to keep them alive, learning and thriving.
We’re not talking about hypotheticals.
These changes would make coverage harder to qualify for, reduce services and discourage doctors from even accepting Medicaid. The bipartisan Congressional Budget Office warns that more than 11 million Americans could lose coverage under this bill—including millions of children. The rollback of retroactive eligibility alone would cut families off from backdated coverage they rely on after unexpected medical emergencies. These are the kinds of changes that don’t make headlines—but they break households.
So where does that leave us?
It leaves us with hard choices—and urgent action.
Black communities must mobilize now to defend what generations have fought for: dignity, care, and the right to be well. Call your representatives. The Congressional switchboard is 202-224-3121. Tell them to oppose H.R.1 and reject any effort to cap, block or dismantle Medicaid and CHIP.
This is not just about budgets; this is about lives.
Share your story. If Medicaid helped your mother walk again after a stroke or helped your child breathe easier through asthma, tell that truth. These programs aren’t luxuries. They are the floor beneath our families—and they are cracking.
Support the organizations in our neighborhoods doing the work: the health clinics, legal aid groups and Black-led advocacy groups fighting in statehouses and courtrooms alike. And vote. Local and state elections determine how Medicaid gets implemented. We cannot afford to sit this one out—not when our loved ones’ care is on the line.
This is more than policy. This is personal.
We’ve endured generations of medical neglect, mistrust and exclusion. We can’t allow our silence to make us complicit. Our grandmothers deserve care with dignity. Our children deserve to grow up strong. If we don’t fight now, they will be the first to feel the cut—and the last to be heard.
The test of a nation is how it treats its most vulnerable. We already know the answer. But this time, we still have a chance to change it.
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