by David R. Jones, Esq., President and CEO of the Community Service Society of New York via Amsterdam News

Of all of President Donald Trump’s alarming and cruel policies, the gravest threat to New Yorkers may be the Republican-controlled Congress’ plan to dramatically cut Medicaid to fund tax cuts for corporations and the rich.

Imagine the hardship of slashing and burning Medicaid, the largest federal program for alleviating the burden of health care costs, on the fragile social and economic fabric of the five boroughs: households, hospitals and medical clinics, insurance companies, doctors and nurses aides, and long-term care facilities. The devastation would be irreparable.

New York City children are especially at risk. Just over half of all city children are covered by Medicaid, according to the Citizens’ Committee for Children of New York. They live overwhelmingly in the Bronx, Queens and Brooklyn. Their families are already struggling to make ends meet because eligibility for federal health care is based on age, family income in relation to the Federal Poverty Limit, and residency status.

Six New York congressmen are members of the Republican House majority, and 730,000 of their district constituents on Medicaid and state health plans would suffer under these cuts. They need to hear from New Yorkers – both inside and outside their districts — who will be impacted by these cuts to make them think twice about toeing the Trump line.

Statewide, nearly seven million New York residents are enrolled in Medicaid. And  eight percent of the total 83 million low-income people nationwide – one in five people living in the U.S. – depend on Medicaid, says the health policy research website KFF.   The recipients include the poor as well as many individuals who are working low-wage jobs that do not offer health insurance.

Medicaid is a much bigger program, in terms of the number of people covered, than Medicare: 83 million versus 68 million, according to the Center for Medicare and Medicaid Services. In addition to $880 billion in Medicaid cuts over the next decade, the budget ax would also put at risk New York health programs such as the Essential Plan, Child Health Plus and the Qualified Health Plan.

The Republican budget proposes $4.8 trillion in tax cuts, most of which benefit very high income and net worth individuals. These tax giveaways would ultimately increase the national debt by $2.8 trillion. It would also expand income inequality and income inequity while taking away housing, food, healthcare, education and federal support for other basic necessities from those amongst us who have the least. These cuts will hurt the nation’s poor and working-class people.

The Republicans are following a script laid out in Project 2025, a policy playbook authored by the conservative Heritage Foundation.  Every page offered extreme proposals to dramatically shrink government, increase presidential power and repeal gains by the poor and people of color in every arena, from education and infrastructure to health care and LGBTQ rights.

Trump, whose policies hurt his strongest supporters, did not utter the word Medicaid during his lengthy address to Congress last week.  It is safe to assume Medicaid was missing because red states that supported Trump would suffer deep cuts because of it, and from the loss of badly needed medical facilities. According to one recent poll, 71 percent of Trump voters say that cutting Medicaid would be unacceptable.

Among seven states with more than 25 percent of their population on Medicaid, four of them – Louisiana (32.4), Kentucky (28.3), West Virginia (28.2) and Arkansas (27.4) – voted overwhelmingly Republican in the 2025 election, according to the health policy researcher KFF.   Medicaid covers more than 50 percent of children in small towns and rural areas in six states: Arizona, Arkansas, Florida, Louisiana, New Mexico, and South Carolina, according to the Economic Policy Institute,

Those numbers fly in the face of the perception pushed by conservative Republicans that Medicaid is politically unimportant – a safe target for cuts – because it’s mainly a program for inner-city people of color. If Republicans think they can slash Medicaid without paying a heavy political price, because only “those people” will be hurt, they’re deeply mistaken.

Medicaid is especially important for rural and small-town Americans, even if they aren’t direct beneficiaries themselves, because it helps keep health-care facilities open. Deep cuts could devastate America’s teetering rural health care system and jeopardize Republicans’ political power among rural voters.

The Medicaid cuts that take health care from the needy, as well as the federal government’s moves to stop food and medicine to Africa and break up families using deportations, are tied together by a similar string: Cruelty is the point in the name of tax breaks.