Medicaid/Medicare in danger as it turns 61

(This column by Lida Shepherd ran in West Virginia Watch last week.)

 Last week marked the 61st anniversary of Medicare and Medicaid, and with so many dire threats to both health care programs, we would do well to reflect on their history and the promises delivered to millions of Americans since they were signed into law six decades ago in Independence, Missouri.  

On July 30, 1965, President Lyndon B. Johnson signed the Medicare and Medicaid Act, marking the beginning of Medicare, a health insurance program for people over 65, and Medicaid, a health insurance program for people with limited income. 

At the bill-signing ceremony, former President Harry Truman and his wife Bess were enrolled as Medicare’s first two beneficiaries and received the first Medicare cards.  President Johnson then recognized Truman for his 20-year effort in pushing for a national health insurance program. As far back as 1948, Truman, while campaigning for reelection, had said, “I put it to you, is it un-American to visit the sick, aid the afflicted or comfort the dying? I thought that was simple Christianity.” Truman won reelection, however he faced impossible opposition from Congress, and would have to wait 20 years to see his dream of a national health care program fully realized. Truman then remarked at the ceremony, “Mr. President, I am glad to have lived this long and to witness today the signing of the Medicare bill which puts this Nation right where it needs to be, to be right.”

Today’s Medicare program provides healthcare for 70 million senior Americans. Prior to President Donald Trump’s so-called “Big Beautiful Bill” passed in July of last year, nearly 81 million Americans received health care through Medicaid. But in passing that bill, the GOP controlled Congress, including our entire delegation, made the single largest cut to healthcare in U.S. history, with a $1 trillion cut to Medicaid alone. In only one year since that fateful vote, a staggering 8 million Americans have already lost healthcare coverage. And for what? To pay for tax breaks for billionaires and big corporations.  

And the hits from the Trump administration keep coming: last week the Centers for Medicare & Medicaid Services announced that it will end Medicare Part D, a subsidy program that stabilizes premiums of prescription drug plans, impacting nearly 25 million seniors and people with disabilities who afford prescriptions through that program.

The elimination of Affordable Care Act tax credits coupled with onerous eligibility restrictions have also led to skyrocketing premiums and a precipitous drop in the number of people with health care coverage. We can expect that healthcare enrollment will continue to deteriorate as people on Medicaid struggle to reckon with the mountains of paperwork now required around work reporting requirements and redeterminations — scheduled to go into effect in January 2027.  

According to Steve Davis, a professor in the department of health policy management at West Virginia University, “You will see less utilization of healthcare services because people no longer have insurance. So less utilization, less access to health care and more sickness, morbidity and potentially even mortality. And that is more costly for us all.”

The president and our members of Congress have turned their backs on the needs of West Virginians. This may come at a great political cost as the damage is felt by more and more people in terms of higher costs, loss of coverage, bankruptcies, hospital closures, preventable deaths and job loss.

President Johnson, in his praise of President Truman for his unwavering commitment to a national health care program, said, “And just think, Mr. President, because of [Medicare and Medicaid] — and the long years of struggle which so many have put into creating it — there are men and women in pain who will now find ease. There are those, alone in suffering who will now hear the sound of some approaching footsteps coming to help. There are those fearing the terrible darkness of despairing poverty — despite their long years of labor and expectation — who will now look up to see the light of hope and realization.”  

Instead of hope or help, today’s approaching footsteps are bringing misery to millions of Americans.  But at some point, hopefully soon, they will wake up a sleeping giant.  

Big Brutal Bill one year out

 This July 4th wasn’t just the 250th birthday of the United States. It was also the one-year anniversary of the signing of House Resolution 1, aka the Big Brutal Bill, which will cut hundreds of billions of dollars from basic food assistance and health care to provide yet more tax cuts for the very wealthy and pour more money into repression.

Cuts to health care alone have been estimated by Yale and the University of Pennsylvania to cause 51,000 premature deaths each year when fully implemented due to disenrollments from Medicaid and Medicare, rolling back nursing home staffing rules, and cuts to premium benefits from the Affordable Care Act.

According to the Center for Healthcare Quality & Payment Reform, around 700 rural hospitals—one third of the total—are at risk of closing. For around 300, the risk is immediate.

The damage is only beginning but will get much worse over the next several years. It’s a gift that keeps on taking. 

The most immediate damage is from people losing SNAP food assistance. More than 4 million have lost benefits since Big Brutal was signed. In 12 states with available data, 700,000 of those who lost food aid were children as of May 2026. The total number is anyone’s guess. SNAP changes may also reduce the eligibility of kids  from low-income families to access free school meals or summer benefits.

The Center on Budget and Policy Priorities calculates the SNAP rolls in West Virginia have declined by 5.3 percent or around 15,000 individuals between the bill signing and March 2026. That’s more than the entire population of Tucker and Pocahontas counties. And these are just the beginning of sorrows.

Another threat to food security in West Virginia caused by the bill is the cost shift to states based on SNAP error rates with error rates of over- or underpayments over 6 percent. In 2025, our error rate was 6.69 percent, better than the US average of 10.62 percent but still enough to cost the state around $30 million, assuming the governor and the legislature have the political will to make up the difference. 

(I’m not sure I’d bet the farm on that happening.)

There is one thing that our congressional delegation, which unanimously voted for the bill, can do to reduce at least some of the harm by way of the federal Farm Bill, which is now being considered in the Senate. It’s pretty simple: give states more time to bring down error rates to avoid hits to state budgets and/or making more people hungry. And our senators could  make that happen.

SNAP benefits are not generous and never have been. In West Virginia, they amount to less than $6 per person per day, around the cost of a happy meal from McDonalds. But they are a lifeline for over 270,000 West Virginians or more than one out of six of us. And they help support local jobs, businesses, and farms all over the state. 

I hope that matters this time around.

(This ran as an op-ed in the Charleston Gazette-Mail.)

Calling the bluff on Mother's Day rhetoric

This piece by Lida Shepherd appeared on the AFSC website and in a slightly different form in the Charleston Gazette-Mail. 

As far back as I can remember, my mom has eschewed the popular traditions of Mother’s Day, seeing the cards and the flowers as a bit shallow. Anna Jarvis, the founder of Mother’s Day, first commemorated it here in my home state of West Virginia. She had similar sentiments.    

Toward the end of her life, Jarvis lamented that the holiday had become too commercial, and a travesty of her original vision that we honor our mother for “the matchless service she renders to humanity in every field of life.”   

On Mother’s Day this year, I want to honor both my mother and Anna Jarvis, by asking whether we as a country are honoring mothers everywhere for their “matchless service”?    

The answer is clear: because despite the proclamations and platitudes of elected officials, their policy choices have made life harder for the majority of moms. The basics of a good life—an affordable home, quality healthcare, healthy food, a good-paying job with childcare, and beyond—are more out of reach than ever.    

So, as President Trump and members of Congress prepare to wish moms everywhere a happy Mother’s Day, we need to ask—and answer—the question: “What have you done for moms lately?”  

The record speaks for itself. Last year, the Trump administration cut over 7,000 workers from the Social Security Administration. The result has been a massive backlog, with people waiting months before getting an appointment to receive the benefits they rely on, including SSI (Supplemental Security Income) and SSDI (Social Security Disability Insurance).   

These layoffs particularly impact moms. Mothers are 92% of those seeking survivors benefits, according to 19th News. And because women live longer and also face pay disparities, they are more likely to rely on their spouse’s Social Security benefits.   

Here in West Virginia, several more Social Security offices closed just a couple of weeks ago.  In a rural state like ours—where people have major barriers to transportation and Internet access—these cuts and closures leave mothers and grandmothers desperate about whether their Social Security check will arrive.     

And for moms already stretched thin, food security is under threat, too. Last year, Congress—including West Virginia’s entire congressional delegation—voted to pass Trump’s so-called “Big Beautiful Bill” (H.R. 1). The bill slashed funding for the Supplemental Nutrition Assistance Program (SNAP) by $186 billion—the largest cut to the program in history. An estimated 4 million people will see their SNAP assistance terminated or cut substantially.   

West Virginia moms, especially in rural areas, rely on SNAP to put food on the table for their families. How can anyone claim to honor moms while taking food away from their kids? 

The cuts don’t end there. H.R. 1 also eliminated federal subsidies that have made healthcare affordable for millions of families. West Virginia moms could be hit hardest by increases in monthly health insurance premiums, according to KFF. Monthly premiums are projected to spike by up to 654% (from $602 to $4,540).   

In West Virginia, over 44% of mothers receive their healthcare through Medicaid. And H.R. 1 spares them nothing. With the cuts and policy changes to Medicaid contained in the bill, up to 37% of people, including moms, will likely be kicked off Medicaid. Moms will lose health care access not because they aren’t working or aren’t exempt from the reporting requirements, but because the new policies are designed to drown people in paperwork.  

We are already feeling the impact in West Virginia as rural hospitals prepare for severe funding shortages. Where I live in Greenbrier County, the local hospital recently ceased offering OB/GYN services. Now, expectant moms must travel over an hour to receive care for themselves and their baby. 

For even more examples of cruelty from our federal government, look no further than the Trump administration’s proposed budget for next year. It proposes:  

Eliminating Head Start and Early Head Start. The program serves more than 700,000 children and their families nationwide—including 8,499 in West Virginia. It also provides early childhood and family services and helps connect parents to resources like job training.    

Eliminating the Low-Income Home Energy Assistance Program (LIHEAP) and the Community Services Block Grant (CSBG). These programs help moms and their families afford home heating and cooling costs. Meanwhile, Appalachian Power—our electric company here in West Virginia—just filed a notice of its intent to ask for another base rate increase. If approved, moms will see a 4% base rate increase as soon as March of next year.   

Eliminating Early Childhood Mental Health Supports. That includes the Substance Abuse and Mental Health Services Administration’s Infant and Early Childhood Mental Health (IECMH) grants and Project LAUNCH (Linking Actions for Unmet Needs in Children’s Health). 

The Trump administration’s budget would even make it harder for low-income moms to buy fruits and veggies for their kids. It would cut the monthly WIC fruit and vegetable benefit by $1.4 billion, reducing it from $54 to $13 for breastfeeding mothers and from $27 to $10 for young children. 

While moms lose food assistance, healthcare, and other supports, big corporations and the superrich continue to post record profits—using tax breaks and loopholes also contained in H.R. 1. The burden is being shifted onto working moms and families who can least afford it.   

The struggles mothers face today are not of their own making. They are the direct result of elected officials who have chosen to prioritize the wealthy elite over the everyday working people whom they were elected to represent.   

Like activist Carol Hanisch wrote in her seminal 1969 essay, “Personal problems are political problems. There are no personal solutions at this time. There is only collective action for a collective solution.”   

Today, one collective action we can all take is making very clear who in leadership is responsible for our problems. Then, it is up to us to hold them accountable. 

This Mother’s Day, we invite you to take action. Join us in calling on Congress to reject the proposed federal budget that would further harm mothers and families across the country. Instead, we must invest in food, health care, and human needs that ensure all people can thrive.  

Reconsidering the definition of crime

 I’ve been thinking lately the definition of crime—or at least the way it’s treated—is kind of relative. The consequences of a harmful act differ widely depending on the social and economic position of the person or group that does the harm.

Corporations and CEOs whose safety shortcuts harm or kill workers on the job usually get away with it, while working class and poor people do serious time for minor offenses.

Some wealthy people cash in on subsidies for industries that damage water, land, wildlife, and public health… but a poor person can get nailed for littering (not that I’m in favor of littering).

Executives at financial institutions whose predatory practices have wiped out families’ life savings have gotten huge bonuses, while petty theft is often punished.

Woody Guthrie summed this up in his Ballad of Pretty Boy Floyd, about a Depression-era robber who became a kind of folk hero:

            Yes, as through this world I've wandered

            I've seen lots of funny men;

            Some will rob you with a six-gun,

            And some with a fountain pen.

To bring Woody up—or down—to date, I’d also have to say that some will kill with a weapon and some with a vote or a policy decision. And it’s happening here and now.

We can start with the impact of cuts to health care in the Big Brutal Bill (not counting the hardships caused by the recent shutdown). Earlier this year, public health officials from Yale and the University estimated that cuts to Medicaid and other health programs would cause 51,000 U.S. deaths per year when fully implemented.

Specifically, the researchers estimate that 42,500 lives could be lost each year from disenrollments in Medicaid and Marketplace coverage and the rollback of nursing home staffing rules. An additional 8,811 deaths are projected from the expiration of the enhanced Affordable Care Act (ACA) Premium Tax Credits, bringing the total to more than 51,000.

That doesn’t count collateral damage of the current government shutdown or collateral damage done by cuts to other programs such as food assistance or the ongoing damage caused by hospital closings, job losses, debt, stress, and economic insecurity.

To quote Bishop William Barber, “We have to start talking about this budget as a form of social and political murder, social and political deadliness, because they know. And the reason I use the word ‘murder’ is because they know that it’s going to cause death.”

Then there are the even greater number of premature deaths that are already starting to happen in the world’s less wealthy nations due to cuts in USAID food and health assistance since the agency was effectively killed this year, with the majority in congress supporting still more cuts to spending already allocated.

No program is perfect, but a study of USAID work over the past 21 years published in the British medical journal The Lancet showed that it really was working before it was gutted.

During those years when it was functioning, the researchers found a 15 percent decrease in mortality rates by all causes and a 32 percent decrease in children dying under age five. That amounts to helping around 91 million people overall and more than 30 million kids.

This includes a 65 percent reduction in mortality from HIV/AIDS, representing 25.5 million lives saved; 51 percent from malaria, or 8 million; neglected diseases, for around 9 million; as well as decreases in death caused by tuberculosis, nutritional deficiencies, respiratory infections, and maternal and perinatal conditions. These beneficial effects were felt in dozens of countries. Between 2017 and 2000, the program provided assistance in 240 natural disasters and crises.

That was then; this is now. According to forecasting models used by the Lancet author, the cuts will result in more than 14 million additional all-age deaths, including over 4.5 million children under five by 2030.

Compared to these numbers, movie bad guys seem like amateurs.

And none of this had to happen. We’re not like dinosaurs hit by a meteor or medieval peasants suffering from famine through a crop failure or plague victims who haven’t figured out how to wash their hands. All of these deaths could have easily been prevented, And many of our leaders who could have helped block this went along with it.

Washing one’s hands of innocent suffering didn’t do much for the reputation of Pontius Pilate… and I doubt it will for others in the long run.

This piece by was originally published on December 12, 2025 in the Charleston Gazette-Mail.

Shutdown hunger games

 Over a century ago Will Rogers, famous for both his acting and pithy social commentary, quipped, “Ten men in our country could buy the whole world, and ten million can’t buy enough to eat.”   Were he alive today, he would have to amend it to say that while 10 men can still buy the whole world, 42 million can’t buy enough to eat.

Because President Trump, while hosting a lavish “Great Gatsby” themed party at his resort in Mar-a-Lago, directed the U.S. Department of Agriculture to withhold SNAP benefits from 42 million children, veterans, and seniors, all while boasting about his new marble bathrooms and gilded ballroom.  

These kinds of gross displays of extreme wealth against a backdrop of desperate poverty have become a common feature of American life today.  A cursory look at how some of the richest people are presently fairing gives us a sense. 

Jim Walton, heir to the Walmart fortune, saw his wealth rise by192 per cent since Trump’s corporate tax breaks were enacted in 2017.  According to Americans for Tax Fairness, this translates to an additional $80 million in just eight years for Jim Walton.

By contrast, a young woman working as a cashier at Walmart recently told me that she was worried about how she is going to feed her nine-month-old baby after WIC benefits were taken away.  She said she works as much as she can at $11 an hour, but her Walmart wages are not enough to afford formula and food, so she relies on WIC to ensure her baby is getting enough to eat.  Accounting for inflation she is making even less in real wages over the same time period Mr. Walton’s fortunes have skyrocketed.  

How do we understand the level of precarity facing millions of people like her when today America’s 916 billionaires have now amassed $8 trillion, a 172 per cent increase since the enactment of the 2017 Trump tax law?  

Joseph Stiglitz gives an answer from his perspective as a Nobel prize winning economist.  In The Price of Inequality: How Today's Divided Society Endangers Our Future he points out, “There are two ways to become wealthy: to create wealth or to take wealth away from others. The former adds to society. The latter typically subtracts from it, for in the process of taking it away, wealth gets destroyed.”  From this perspective, the extraction of wealth from working people is what is fueling today’s extreme levels of poverty and wealth inequality. 

This extraction and concentration of wealth is made possibly by the policy decisions made by those in power, and to that, Will Rogers has a related quip: “America has the best politicians money can buy.”  As illustration, West Virginia’s entire congressional delegation voted for the “Big Brutal Bill” which permanently extended Trump’s 2017 corporate tax cuts, partly paid for by cutting health care and food access for West Virginians and other struggling Americans. 

Yes the Federal Government is still shut down as President Trump and our representatives in Washington refuse to side with Democrats and restore the premium tax credits that allow West Virginians to access health care.  Even so, the Administration can designate contingency and carryover funds to keep SNAP running, as the USDA has done during previous shutdowns. It can also transfer funds from other accounts to make up any shortfall.

In open letter to West Virginia’s four senators and representatives and signed by over 40 food banks, churches, and advocacy groups, they stated, “Allowing SNAP and WIC payments to lapse and hunger to deepen during a shutdown is a policy choice and a preventable cruelty.”

These same groups also requested that each of our senators and representatives sit down as soon as they can with West Virginians who are experiencing the crushing stress of whether or not they will have enough food for their loved ones to eat.      

If our leaders continue to prioritize wealthy donors and the corporate elite over the thousands of West Virginians struggling to afford health care and food, then you can count on Will Rogers for some final words of wisdom: “The short memories of the American voters is what keeps our politicians in office.”  So let us not forget next time.  

This column by Lida Shepherd, director of the American Friends Service Committee WV Economic Justice Project, appeared in today's Charleston Gazette-Mail.