The Baltimore Sun Feb 22, 2025

We both attended the U.S. Senate Committee on Health, Education, Labor and Pensions hearing for Robert F. Kennedy Jr. on Jan. 30. When reflecting on the many commitments Kennedy made to U.S. Sen. Bill Cassidy, a Louisiana Republican, that day in order to gain his critical vote to become the next Health and Human Services (HHS) secretary, the words of Dionne Warwick’s song sadly ring true. “You made me promises, promises. Knowing I’d believe promises, promises. You knew I’d never keep.”

Senator Cassidy, a gastroenterologist with over 30 years of experience, proudly claims that he has dedicated his life to saving lives and we do not disagree. Throughout Kennedy’s confirmation hearings, Cassidy reiterated his support for vaccines, having personally witnessed their rigorous safety monitoring and effectiveness throughout his career. He also brought up his grave reservations about Kennedy’s past conspiracy theories and vaccine cynicism.

In order to vote yes to confirm Kennedy, Cassidy obtained several promises. He made it clear during his floor speech that preceded the full Senate vote he would be watching for any efforts made by Kennedy that would wrongfully sow public doubt about vaccines. Yet, just days after being sworn in and despite his pledge that he would not change the nation’s current vaccination schedule, in his very first address to HHS employees, Kennedy vowed to investigate the childhood vaccine schedule that prevents measles, polio and other dangerous diseases (“Kennedy says panel will examine childhood vaccine schedule after promising not to change it,” Feb. 18).

The fledgling HHS secretary’s timing could not be worse. Currently, there is a serious outbreak of measles in Texas with 58 reported cases, most of these in children. Measles is dangerous, potentially deadly, highly contagious and is spreading rapidly to other states.

Kennedy also has a history of drawing false conclusions about vaccines, often linking them to unrelated, unproven end results. His most widely known and repeated lie is that vaccines cause autism. They do not. Now, in his mission to “make America healthy again” by decreasing chronic health conditions, he announced he wants an investigation linking the cause of these diseases to vaccinations. Several meta-analysis studies have tested this hypothesis and found that no link exists between vaccines and chronic disease.

Doctors for America and Nurses for America opposed Kennedy’s nomination, never fooled by RFK Jr’s insincerity. This may have been his first promises broken, but they will not be the last. Senator Cassidy, it’s your move now.

— Timothy Holtz, M.D. and Teri Mills, R.N., Chevy Chase

The writers are, respectively, a professor at the George Washington University Milken Institute School of Public Health and the former president of the National Nursing Network Organization.

The Republican-led House Budget Committee has announced details of its 2025 Budget Reconciliation bill. Surprisingly, their proposal doesn’t focus on the waste and fraud you might expect. It calls for slashing Medicaid funding by $880 billion in the next 10 years.

The Republican party sent their leadership to Mar-A-Lago last month to outline budget priorities with two objectives: to reduce the federal deficit and fulfill Trump’s campaign promise to extend the 2017 tax cuts that went to those with incomes above roughly $400,000. Extending those tax cuts would provide an average annual tax reduction of $62,000 for households in this top 1% of earners.

Pennsylvanians, along with all Americans, have reason to be alarmed.

Alarming for Pennsylvania

In 2024, 3.1 million of the state’s population were covered by Medicaid and the Children’s Health Insurance Program (CHIP). Medicaid operates as a shared financial responsibility, with costs covered by both federal and state governments.

In fiscal year 2022, total Medicaid spending in Pennsylvania was $44 billion. The federal government paid 63.5% of these Medicaid costs and the state budget picked up the rest. Without help from the federal government, the Pennsylvania legislature would struggle to fund the steep cost without making deep cuts to education and public safety.

If the cuts are made, how will they affect patients and their families? Medicaid, established in 1965 as part of the Social Security Amendments, was intended to provide healthcare coverage to America’s poorest people.

Today, with specific criteria, most states cover children, adults with disabilities, aging adults and non-disabled adults. Medicaid also makes payments to hospitals and long term care facilities that serve a large number of Medicaid and low-income uninsured patients to offset uncompensated care costs.

As nurses, we have cared for countless Medicaid patients and seen the life-changing impact of this coverage. Now, these same patients live in fear of losing the care they rely on.

Devastating cuts

One professional told us, “I am a nurse working in an assisted living, long-term care facility. I would estimate 80% of the patients I care for are on Medicaid. These proposed cuts will devastate my community.”

Her patients wouldn’t be the only victims. “Like many who work in hospitals and settings that rely on Medicaid government reimbursement, I would likely lose my job. This is a double whammy for my family, as I work part-time, so am not eligible to receive benefits through my employer. I too rely on Medicaid and the same goes for my three children.”

Another Medicaid recipient said, “I'm a single mom with disabilities, including temporal lobe epilepsy, fibromyalgia, and two types of lupus erythematosus. I have a special needs child who depends on anti-rejection meds due to a liver transplant. Without Medicaid, we could not afford our medications and this would be a death sentence for us.”

A concerned grandmother reports, “My 12-year-old granddaughter was just diagnosed with significant scoliosis at 45° and 47°. She will almost certainly need corrective surgery. If Medicaid is cut, her parents will not be able to afford over $100,000 for this surgery, and the curvatures in her spine will continue to get worse.”

There are 3.1 million stories just like these, and that’s just in Pennsylvania alone. The Kaiser Family Foundation reported that 82 million Americans were enrolled in Medicaid as of August 2024.

When pressed on improvements he would make to Medicaid during his confirmation hearing in the Finance Committee, Robert F. Kennedy Jr. provided no specific examples.

He simply declared that “Medicaid is not working for Americans and most Americans prefer private insurance.” Actually, those who have Medicaid are satisfied with their plans, with 80% of enrollees viewing their insurance positively.

He also refused twice to commit to protecting Medicaid funding, saying both times that he would work with President Donald Trump to make Medicaid “better,” but he failed to say he would rule out cuts or to provide any further specifics. He’s now the head of the Department of Health and Human Services.

On the chopping block

Is this a doomsday scenario for Medicaid and the people who depend upon for their health, and even their lives? Not yet — but we’re dangerously close. Republicans only need a simple majority in the Senate to pass this measure — no filibuster, no 60 votes required. That means Medicaid is on the chopping block, and millions of lives are on the line.

The House of Representatives is our last line of defense. With the GOP holding a razor-thin 218-215 majority, very single vote matters — and so does your voice.

Donna Gaffney and Teri Mills are leaders in Nurses for America. Their previous article was “Mr. Fetterman and Mr. McCormick, say no to RFK Jr.”.

First Published: February 21, 2025, 2:30 a.m.

Less than a month into the Trump presidency, critical protections and incentives to improve health and safeguard public safety in the U.S. have been rescinded and a vaccine cynic, Robert F. Kennedy Jr., who struggled to answer basic questions about Medicare and Medicaid during his hearing, has been confirmed as Health and Human Services (HHS) Secretary.  

There is now uncertainty about the future of Medicaid with the House GOP-led Budget Committee recommending steep cuts in funding to the tune of $880 billion over the next ten years. Also, included in their reconciliation bill is roughly $150 billion in reductions to the Supplemental Nutrition Assistance Plan (SNAP) that helps to provide free breakfasts and lunches to children. 

One of President Trump’s first actions was withdrawing the United States from the World Health Organization (WHO). To put this exit into perspective, the world’s population is around 8 billion. The only other country within the United Nations that does not belong to WHO is Liechtenstein, population 40,000. Trump’s decision impacts far more than just those within our borders.  Until January 20th, the US was the world’s top global donor, financing programs ranging from HIV to public health emergencies. As Americans work to regain a sense of normalcy post-pandemic, there are already new threats like Avian flu (H5N1) emerging globally.  Withdrawing from WHO comes at an especially critical time as it prevents the U.S. from accessing vital scientific information that drives the development of vaccines and treatments. 

Additionally, President Trump wasted no time in exiting the Paris climate agreement, joining Iran, Yemen and Libya as non-participating countries. Although there has been ample gasoline in the U.S. currently selling for an average of $3.25 a gallon as compared to 6 to 8 dollars per gallon in Europe, Trump’s focus on expanding oil drilling -“drill, drill, drill”-will result in increased pollutants entering the atmosphere. Despite global consensus that greenhouse gas emissions drive climate change, Trump refuses to acknowledge that we are facing a climate crisis. Trump signed an order to revoke Biden’s target goal of 50% electric vehicle adoption by 2030, ignoring what we’ve witnessed this past year. Record temperatures have fueled unprecedented weather extremes, underscoring the urgent need for action. We saw catastrophic events including flooding in North Carolina, a snowstorm in New Orleans, and the recent destructive and deadly fires in Southern California, leaving tens of thousands homeless.  Trump justified these policy changes by arguing if China is able to pollute our air, the U.S. should not unilaterally limit its own industries. His actions directly impact all of us, but especially the 35 million Americans living with chronic lung disease who depend on clean air to breathe. 

During his campaign, Trump promised to reduce the cost of living for hard working Americans. He also bragged during his inaugural address he will make America healthy again. Yet, he swiftly signed an executive order revoking the Biden administration’s ability to negotiate drug prices which was a key part of the Inflation Reduction Act. 

Three in ten Americans struggle to pay for their medications. As nurses, working on the frontlines of healthcare, we see all too often patients who cut pills in half or skip them entirely in order to purchase groceries or pay their heating bill. The ability to afford medications has not only improved patients' health outcomes but also led to a $6 billion reduction in spending as reported by the Centers for Medicare and Medicaid Services (CMS).  It’s not surprising a Kaiser Family Foundation poll conducted in October 2024 found strong bipartisan support with 85% of those surveyed supporting the federal government’s negotiation of the price of prescription medications. 

Actions speak louder than words, and President Trump’s pledge, to “make America healthy again” rings hollow. It’s either an empty cliché or a meaningless campaign slogan because his actions so far have directly undermined public health. Every measure he has taken seems designed to erode, not protect, the health and well-being of Americans. Is this what we signed up for?  

Donna Gaffney, Pacific Palisades, CA and Teri Mills, Tualatin, OR (both are leaders in Nurses for America)