As much as geography and culture might separate our two health systems, our shared mission gives us common cause to fight for an endangered federal program that provides a lifeline to the families and communities we serve: Medicaid.
Make no mistake, Medicaid and the Children’s Health Insurance Program are in the crosshairs of a U.S. House budget plan to cut $880 billion in federal healthcare spending. If policymakers stay true to their word and leave Medicare untouched, there is no other way to reach that number without gutting Medicaid. A cut that deep would be disastrous—not only for our health systems but more so for the millions who depend on Medicaid for healthy, productive lives. Cutting Medicaid to the bone would harm working families, wreck state and local economies, and hurt children and rural communities.
At Huntsville Hospital Health System (HH Health), in Huntsville, Ala., we serve 15 counties with 1.4 million people in northern Alabama and southern Tennessee — much of it rural. The population here is mostly white, with a median income of about $67,000 a year. Our hospitals house 2,500 beds and employ more than 19,500 people. As a regional referral center, we operate North Alabama’s only level I trauma center and women’s and children’s hospital.
Humbolt Park Health operates on a more modest scale on Chicago’s West Side, home to about 480,000 people across multiple urban communities. Our 200-bed acute-care campus has a service area where nearly 80 percent of residents are people of color and population density is among the city’s highest — about 14,000 people per square mile. We serve poor neighborhoods, many with a per-capita income of less than $15,000 a year.
While our communities look different, our patients depend just the same on Medicaid and the safety net it offers to working families, children, and the elderly.
In the counties HH Health serves, for example, the Medicaid and CHIP coverage rate among children is nearly 50 percent. This is true for most of Alabama — and, especially, its rural communities here and nationwide. In the HH Health coverage area overall, more than a fifth of elderly and non-elderly adults and children rely on Medicaid to stay well and productive.
This couldn’t be truer than in Alabama’s Lawrence County, where the closure of the county’s only emergency department, in Moulton, was recently announced. As HH Health works with community leaders to maintain emergency response and keep outpatient services open, we need every single dollar — Medicaid included — to maintain access to essential primary care. Threats to reimbursement come at a time when Lawrence County is enjoying economic success: This is the home of Red Land Cotton. First Solar Inc. opened a $1.1 billion manufacturing facility in 2024. Lockheed Martin Corp. has a 30-year history here. Medicaid funding is critical to maintaining the local access to care that allows this wonderful rural community to thrive.
About 600 miles to the north, at Humboldt Park Health, Medicaid coverage means early intervention for seriously ill patients. A 63-year-old patient received a routine breast cancer screening, which led to the early detection of cancer and allowed her to undergo surgery, radiation, and chemotherapy. Today, she is a survivor, in remission, and living a full life — an outcome that might not have been possible without the access to care Medicaid provides. Consider the devastating news a 45-year-old mother of three received when diagnosed with a rare and life-threatening kidney disease. Medicaid made it possible for her to receive a kidney transplant and ongoing surveillance to ensure her organ remains functional. Without it, she would have faced a far different reality. These are only two examples out of the thousands of Medicaid patients that receive care at Humboldt Park Health each year.
Like our patients, our health systems need Medicaid—and would suffer, as well, if Congress and the administration dramatically shrink federal health care dollars. Humboldt Park Health and HH Health, like all safety net systems, rely on various sources of federal, state, and local funding to meet their mission of caring for people who need a hand up. Our systems need this support because our mission means high uncompensated and under-compensated care costs. In fiscal year 2024, HH Health sustained more than $171 million in uncompensated care costs; in 2022, Humboldt Park Health provided $3.7 million in uncompensated care.
Medicaid provides a critical part of the funding patchwork that keeps the lights on at safety net health systems and ensures low-income working families and others can access affordable care. For example, at Humboldt Park Health, 75 percent to 80 percent of patients have Medicaid — and that’s not uncommon among essential hospitals. Beyond access to care, Medicaid also provides a vital economic shot in the arm: Essential hospitals like ours supported $283 billion in economic activity and 6.7 million jobs across the country in 2022, including in many rural and low-income communities. HH Health alone contributes more than $4.2 billion annually to the North Alabama economy.
But those economic benefits would fall away if policymakers cut Medicaid by nearly a trillion dollars. States, faced with offsetting federal funding cuts to keep their Medicaid program afloat, will look for cuts of their own — cuts to benefits and providers. In turn, that harms not only health but also jobs and economic activity, and the tax revenue that goes along with both.
So, there is no good outcome possible from the cuts congressional lawmakers propose, and the harm they cause will fall hardest on low-income working families, children, the elderly, and underserved rural and urban communities. We urge policymakers to choose a different path and protect the safety net for all Americans, from West Side Chicago rowhomes to Northern Alabama farms and all points beyond.
Jeff Samz is CEO of Huntsville Hospital Health System in Huntsville, Ala. José R. Sánchez is president and CEO of Humboldt Park Health in Chicago.
