Alliance Alert: The recently enacted “One Big Beautiful Bill Act” threatens to devastate Medicaid, with disproportionate harm falling on Black and Brown communities who already face the harshest inequities in our health system. As Politico reports, nearly 60% of Black children rely on Medicaid, and Black women, children, and families make up a disproportionately high share of those who will lose access to critical services if these cuts take effect.
Cuts of this magnitude would ripple across schools, communities, and health systems, reducing access to essential screenings, school-based supports, and early intervention services. Black families, already navigating barriers to culturally competent support, will be left with even fewer resources. Without robust, community-based, voluntary services, more individuals of color will be funneled into forced treatment programs or criminal legal system involvement—systems that have historically punished rather than supported them.
This is not just a budget issue. It is a matter of racial justice and equity. The lack of culturally competent engagement in services has long driven poorer outcomes for communities of color, and Medicaid cuts will only magnify these disparities.
At the Alliance’s Annual Conference this September, we will host workshops on more effective engagement for people of color and strategies to push back against harmful federal policy changes. We will uplift the voices of people with lived experience, community leaders, and advocates who are building solutions rooted in empowerment, equity, and justice.
Unbreakable! Harnessing Our Power, Building Our Resilience, Inspiring Hope and Courage
Alliance for Rights and Recovery 43rd Annual Conference
Villa Roma Resort and Conference Center | September 29-October 1, 2025
Register Today Here!
The path forward must not be one of neglect, coercion, or criminalization. It must be built on voluntary, community-driven services that honor culture, dignity, and choice—and it will take action from individuals, the state, and Congress to ensure these critical supports are protected.
Medicaid Cuts’ Disproportionate Toll
By Kelly Hooper and Sophie Gardner | Politico | August 19, 2025
ADVOCATES WORRY — Medicaid cuts in President Donald Trump’s tax and spending law could disproportionately harm Black women and children who depend on the program, advocates warn.
And the looming changes in the One Big Beautiful Bill Act could worsen already disparate health outcomes among Black Americans, POLITICO’s Cheyanne M. Daniels reports.
Although Black people represent about 14 percent of the U.S. population, they account for more than 20 percent of Medicaid enrollees, according to Pew Research Center — and almost 60 percent of all Black children are enrolled in Medicaid, according to a recent analysis from the NAACP and other advocacy organizations.
Why it matters: Advocates say the enacted megabill’s Medicaid cuts could limit resources in schools with high percentages of students eligible for free or reduced-price lunch, exacerbate maternal mortality rates and leave Black families without critical care.
“States right now are having to make decisions on what services they’re going to cut … and their allocation of funding toward this population,” said Patrice Willoughby, chief of policy and legislative affairs for the NAACP. “It is unconscionable that Congress would leave American children, which are the future of the country, without the supports that they need and the interventions that they need to contribute meaningfully to develop to their fullest potential.”
Background: Medicaid — which is the fourth largest federal funding source for K-12 schools, according to a 2025 report by the School Superintendents Association — supports more than $7.5 billion of school-based health services each year for low-income students, including screenings for learning disabilities.
Thirty-seven percent of Black students attend high-poverty schools, according to a 2023 analysis by the National Center for Education Statistics.
Through Medicaid, high-poverty schools are also able to provide medical care. They can also provide insight into whether a student needs additional screening for a more accurate diagnosis.
But one report from a coalition of education groups earlier this year found that the Medicaid cuts could force schools to reduce the number of school nurses, limit access to early intervention programs or impact funding for special education programs for those with learning disabilities.
Zooming out: Advocates say the cuts are part of a broader pattern of the American medical system inadequately serving Black patients.
“These cuts really are continuing a pattern of forcing Black families to take care of ourselves without the proper support,” said Brittany Packnett, an equity strategist who co-founded Campaign Zero, a police reform initiative, and supported Vice President Kamala Harris in the 2024 presidential campaign.
In a statement to POLITICO, HHS said the claims “misrepresent” the One Big Beautiful Bill Act.
“The OBBB is a decisive step toward building a stronger, more resilient healthcare system,” an HHS spokesperson said. “This legislation modernizes Medicaid to deliver greater efficiency and long-term sustainability, while expanding access to high-quality care for those most in need, in every community across the nation.”
A spokesperson for the White House also dismissed the worries of advocates, arguing they were coming from supporters of Trump’s defeated 2024 opponent.
Even so: It remains to be seen what the long-term impacts of the cuts will be. Many of the cuts aren’t set to go into effect for years, and Congress has a track record of approving reductions and changing eligibility rules, only to later extend deadlines or revise the law entirely.