Medicaid Cuts Are Coming—Who Will Suffer Most?

by | Mar 3, 2025 | Black New-US, Black Sociology and Politics, Current News Headlines | 0 comments

A cinematic style scene** with chiaroscuro lighting casting dramatic contrasts between warm golden-hour hues and cool, encroaching shadows. **Close-Up:** A Black woman in her 40s with deep mahogany skin and a weary yet resolute expression holds a folded Medicaid eligibility letter, her hands slightly trembling. Her brow is furrowed, and her eyes glisten with unshed tears, reflecting both fear and determination. She wears a threadbare cardigan over a medical gown, a blood pressure cuff still loosely attached to her arm. **Background:** Behind her, a crumbling community clinic’s waiting room fades into soft focus — cracked posters about preventive care peel off mustard-yellow walls, and a barred window casts slatted shadows. A silhouette of a bureaucrat in a suit ominously blocks the doorway, clutching a document labeled “Project 2025.” A faint golden light glows from a flickering “DEI Program” sign above a boarded-up office.
Trumps healthcare policies exacerbate racial disparities through ACA repeal risks Project 2025 Medicaid cuts targeting Black communities DEI removals worsening clinical trials diversitydata visualizations highlight systemic inequities in healthcare access Image generated by DALL E

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Trump Healthcare Policies Ignore Racial Disparity Impact

By Darius Spearman (africanelements)

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Project 2025 Targets Vulnerable Communities

The conservative-led Project 2025 blueprint threatens healthcare equity through Medicaid privatization and benefit caps. Its proposed work requirements demand enrollees prove employment for coverage, which systematically excludes marginalized Black Americans facing job discrimination. Rural hospitals serving predominantly minority communities risk closure under $880 billion in Medicaid cuts proposed over a decade (AFSCME).

Furthermore, repealing the Affordable Care Act (ACA) would expose 21.3 million people to preexisting condition denials, including hypertension and diabetes, which disproportionately burden Black populations. These policies illustrate how bureaucratic technocracy entrenches racial divides while marketing smaller government (Democracy Forward).

21.3M
2024 ACA Enrollees at Risk from Repeal
Source: AFSCME

DEI Removals Worsen Health Inequities

Project 2025’s elimination of diversity initiatives halts progress toward inclusive clinical trials essential for treating diseases like sickle cell, which predominantly affect Black patients. The FDA previously guided researchers to collect racial data to improve care efficacy but these frameworks face dissolution under conservative governance (CBS News).

Moreover, redacting gender-affirming care from federal programs harms transgender people of color who already experience compounded discrimination. Such regressive policy shifts ignore intersectional vulnerabilities and prioritize ideological purity over documented health outcomes (KFF Health).

Black Participation in DEI Clinical Trials
30% of Participants Under DEI Policies
Source: CBS News

Medicaid Cuts Deepen Racial Health Gaps

Lifetime Medicaid coverage limits proposed in Project 2025 would cap benefits at 36 months forcing Black families to ration care for chronic illnesses. Over 34% of Black children rely on Medicaid compared to 21% of white children, making the policy especially destructive (AFSCME).

Additionally, privatizing Medicaid through for-profit insurers risks denying treatments labeled as nonurgent like prenatal checkups, which Black women need 3x more frequently due to maternal mortality rates. This financialization of care exacerbates systemic chasms instead of bridging them (Democracy Forward).

34% of Black children rely on Medicaid — double the rate of white children.
Source: AFSCME

Systemic Change Requires Grassroots Power

Combating these policies demands community-led pushes for Medicaid expansion in holdout states and electing representatives who prioritize healthcare over austerity. Organizations like the ACLU are mobilizing legal challenges to Project 2025’s constitutionality while unions fight privatization efforts (ACLU).

Ultimately sustained advocacy must center Black women and queer voices most impacted by these regressive agendas. Voting and grassroots fundraising provide tools to dismantle structural inequities coded into healthcare laws (Democracy Forward).

About the author

Darius Spearman has been a professor of Black Studies at San Diego City College since 2007. He is the author of Between The Color Lines: A History of African Americans in California. Visit him at africanelements.org.

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