Potential Medicaid Reductions and Their Impact on Maternal Health and Medically Complex Children

As a birth injury lawyer, I work with families every day who are navigating the

devastating consequences of preventable trauma during childbirth. Many of those families rely on Medicaid to access essential care—before, during, and after pregnancy. So when we talk about federal proposals to cut hundreds of billions of dollars from Medicaid, I don’t see abstract numbers. I see patients, parents, and babies who could lose access to the very care they need to survive.

Medicaid Isn’t Just a Safety Net—It’s a Lifeline

Medicaid provides health coverage to over 80 million Americans, including pregnant people, children, people with disabilities, and low-income families. In fiscal year 2023, the federal government and states together spent $894 billion on Medicaid, with about 69% covered by federal dollars. It’s also the largest source of federal funding states receive—and often the second biggest item in a state’s budget, just behind education. The way it works is simple: states pay for health services up front, then the federal government reimburses a share based on a formula called the Federal Medical Assistance Percentage (FMAP). States with lower incomes receive a higher federal match.

What’s Being Proposed—and Why It Matters

On April 10, 2025, the U.S. House of Representatives advanced a budget resolution that includes deep Medicaid cuts. The House Energy and Commerce Committee was directed to identify nearly $880 billion in federal spending reductions, including $625 to $715 billion in cuts to Medicaid and related health programs over the next 10 years. The justification? Proponents claim they want to reserve Medicaid for those it was “intended” to serve—namely, pregnant women, children, people with disabilities, and the elderly. They argue that cutting federal funding will give states more control and help them weed out ineligible enrollees. Proposed changes include work requirements for able-bodied adults without dependents—requiring at least 80 hours of work or school per month to keep coverage.

But here’s the problem: if these cuts move forward, up to 7–10 million people could lose coverage. And those impacted won’t just be able-bodied adults. Families in crisis, including those dealing with high-risk pregnancies, premature birth, or caring for a medically fragile child, are at serious risk of falling through the cracks.

What This Means for Maternal Health

Right now, Medicaid covers over 40% of all births in the United States. It’s also the primary payer for prenatal and postpartum care for millions of women—care that includes mental health services, substance use treatment, and management of chronic conditions. If funding is cut, states will be forced to make impossible decisions: reduce eligibility, cut services, or both. That means fewer women getting prenatal care. Fewer postpartum visits to screen for depression. Less access to specialists when something goes wrong. More complications going undetected. And ultimately, more preventable injuries and deaths—for both mothers and babies. The March of Dimes has warned that the U.S. is already “the most dangerous high-income country to give birth in.” Cutting Medicaid now would only deepen this crisis.

The Ripple Effect on Families With Disabled Children

This isn’t just about pregnancy and birth. Over 2.3 million children with disabilities rely on Medicaid for therapies, equipment, in-home care, and specialist visits. Some families receive up to $1,000 a month in medications alone, not to mention coverage for surgeries or transportation to appointments. If Medicaid is cut, parents may be forced to quit their jobs to provide care themselves—further reducing household income. And for many, that means choosing between medical care and financial stability. There’s another layer too: since the 1980s, Medicaid has reimbursed schools for medical services provided on campus. If that funding disappears, school districts will struggle to serve students with disabilities, potentially violating their legal rights to an appropriate education.

If This Passes—Then What?

As of May 14, 2025, the legislation has moved out of committee and is headed to the House floor for a vote, followed by debate in the Senate. The stated goal is to pass the budget before Memorial Day. But with rising public opposition and uncertainty among lawmakers, the outcome remains unclear. What is clear: if we gut Medicaid, the burden won’t disappear—it will shift. To state budgets. To families. To communities already struggling to get by.

As someone who advocates for families facing the unimaginable, I urge you to pay attention. The consequences of these cuts are personal. They are preventable. And they are unacceptable.