Medicaid is a lifeline for Black communities throughout New York and across the country. More than 1.5 million Black New Yorkers rely on it for essential healthcare, including HIV treatment, maternal care, and chronic disease management. Yet, Congress just voted to cut $880 billion from Medicaid — putting our health and lives at risk.
For many, Medicaid is the difference between life and death. I know this firsthand. As a Black man living with HIV, diabetes, and high blood pressure, I have struggled to get access to quality care. When I was homeless, sleeping in subway cars, I cycled in and out of treatment. I didn’t trust the healthcare system. I was depressed and suicidal, feeling like I had nowhere to turn.
That was before Amida Care; my Medicaid Special Needs Health Plan; and Harlem United, my healthcare provider, helped me rebuild my life.
Without Medicaid, I would never have been able to access and stay engaged in care. When my body became resistant to my HIV medication and I became dangerously ill, they ensured I received the new treatment I needed — even when my pharmacy mistakenly refused to fill my prescription.
Without Medicaid, I would have ended up in emergency rooms, my condition worsening, racking up astronomical medical bills. I probably wouldn’t be here today.
That is why I am deeply alarmed by these proposed Medicaid cuts. They will cripple the program, reducing access to preventive care and forcing more people to rely on overcrowded emergency rooms, leading to worse health outcomes and higher costs for the system overall. These cuts will also devastate our communities economically. Hospitals, clinics, and providers that primarily serve Medicaid patients will be forced to lay off workers or shut down entirely.
The consequences will be felt across every state, but especially in Black communities, where rates of chronic illnesses like hypertension, diabetes, and heart disease remain disproportionately high. Black Americans make up 13.6% of the U.S. population but account for 20% of Medicaid enrollees.
Medicaid expansion under the Affordable Care Act has been the single most effective policy for reducing racial disparities in healthcare access. It led to historic reductions in racial health disparities, but the greatest gains occurred in states that expanded Medicaid. Research confirms that expansion saves lives: States that adopted it saw a 51% reduction in the gap between uninsured Black and white adults. In the states that refused expansion, 1.5 million adults lack coverage, 61 percent% of whom are people of color. Cutting Medicaid would reinforce racial inequities in healthcare and deny communities access to the medical services they need to survive and thrive.
As the largest source of insurance for people living with HIV in the United States, Medicaid is crucial to the fight against HIV and has been instrumental in New York’s efforts to end the epidemic. By ensuring access to lifesaving antiretroviral treatment and preventive care, including PrEP, the program has helped reduce new HIV transmissions and improve health outcomes. Slashing these vital resources would jeopardize this progress, ultimately leading to worse health outcomes and higher costs in the long run.
Medicaid is more than just a health program — it is a pillar of economic and racial justice. It ensures that working-class and low-income families, people with disabilities, and seniors can see a doctor, fill a prescription, and receive lifesaving treatment. Without it, millions will be left without care, deepening racial health disparities and forcing families to choose between paying for medicine or putting food on the table.
I ask our elected officials in Washington: How much is my life worth to you? How much are the lives of millions of Black Americans worth to you? Slashing Medicaid is not just a budget decision; it is a direct attack on our health and our future. We cannot afford to go backward. Our representatives must stand up and protect Medicaid before more lives are put on the line.
Anthony Randolph is a longtime health advocate and member of the Amida Medicaid health plan’s Care: HIV, sexual health, and gender-affirming care experts; and a peer worker in Business Development for Harlem United.