Last week was a tough one for anyone who cares about health care in America. Medicaid, the program that helps millions of low- and middle-income Americans access medical care, took a series of hits. First, the federal system that manages Medicaid funding briefly shut down, causing chaos for hospitals, doctors, and patients. Then, during a Senate hearing, the nominee for health secretary stumbled over basic facts about the program, which covers over 70 million people. And now, House Republicans are floating a plan that could gut Medicaid funding altogether.

Here’s the issue: The Trump administration wants to extend the 2017 tax cuts, which are set to benefit the wealthiest Americans the most. But doing so would add trillions to the federal deficit. To balance the books, some lawmakers are eyeing drastic cuts to health care programs like Medicaid and subsidies that help families afford insurance under the Affordable Care Act. These cuts could make it much harder for millions of Americans to get the care they need.

Medicaid isn’t just a safety net—it’s a lifeline. Over 40% of births in the U.S. are covered by Medicaid, and it’s a crucial source of care for children, seniors, and people with disabilities. Yet, some lawmakers are proposing adding work requirements to the program, even though evidence shows these measures don’t actually encourage employment. Instead, they create bureaucratic hurdles that push people out of the program.

Another idea on the table is to give states a fixed amount of money for Medicaid, regardless of actual health care costs. But states are already stretched thin. With less funding, they’d have to cut coverage or pay doctors less, which could lead to fewer providers accepting Medicaid patients. The result? Less access to care for everyone who relies on it.

And it’s not just Medicaid at risk. Subsidies that make private insurance more affordable for working families could also be on the chopping block. Without these credits, premiums could skyrocket, putting health insurance out of reach for many.

These proposals could have devastating consequences for millions of Americans. Cutting health care to fund tax breaks for the wealthy isn’t just unfair—it’s a threat to the well-being of the most vulnerable.