Illinois lawmakers and advocates sounded the alarm on sweeping cuts coming to Medicare and Medicaid that they said will gut the country’s most vital health programs and disproportionately harm LGBTQ+ communities.
The urgent warning came on the 60th anniversary of Medicare and Medicaid, which the lawmakers honored July 30 at the AIDS Foundation of Chicago, 200 W. Monroe St. Normally, the anniversary would be met with celebration, but instead it was marked by concern and outrage over impending cuts from Republicans’ so-called One Big Beautiful Bill Act.
“Instead of celebrating, we’re fighting,” U.S. Rep. Jan Schakowsky said. “This is the greatest takeaway of what seniors and families need ever in this country. We’ve never seen anything like this before.”
President Donald Trump signed the budget plan into law on July 4. And it will cut Medicaid, Medicare and the Affordable Care Act by more than $1 trillion, kicking more than 15 million people off their health insurance according to the Congressional Budget Office (CBO).
At the same time, the One Big Beautiful Bill Act will give more than $5 trillion in tax giveaways to the wealthy, according to the CBO.
Lawmakers said the cuts would devastate working families, people with disabilities and seniors who rely on public health care. LGBTQ+ policy experts warned the impact would be especially severe for LGBTQ+ communities, which already face barriers to care.
“Any proposed Medicaid cuts would have cascading effects across multiple vulnerable populations within LGBTQ+ communities, potentially undermining both gender-affirming care access and HIV treatment adherence,” Dr. Nathaniel Tran, assistant professor at University of Illinois at Chicago’s School of Public Health, told Windy City Times in an interview.
The human impact of Medicaid cuts
LGBTQ+ policy experts warned that Medicaid and Medicare cuts could be especially severe for people living with HIV, transgender people and LGBTQ+ elders.
Medicaid has been essential for many people living with HIV in the U.S., said Timothy Jackson, senior director of policy and advocacy at the AIDS Foundation of Chicago.
About 40% of non-elderly people living with HIV are enrolled in Medicaid, compared to 15% of the overall non-elderly population, according to an April report from the Kaiser Family Foundation.
“So any changes that we have to our Medicaid system is really going to be a life-or-death situation,” Jackson said. “It provides HIV medication, but it also supports our HIV prevention efforts like testing and new modalities for prevention.”
These cuts would derail efforts to end the HIV epidemic, Jackson said.
The impending cuts are already having a chilling effect on transgender health care in Chicago, with UChicago Medicine announcing July 18 it would discontinue gender-affirming care for patients under 19.
“We reached this conclusion in light of emerging federal actions, which would put at risk our ability to care for all Medicare or Medicaid patients,” UChicago’s statement read. “These patients make up the majority of those we serve.”
“Health systems … have already announced that they will no longer provide gender-affirming care to people under the age of 19, which largely focuses on puberty blockers and hormone therapy,” Tran said. “These health systems rely heavily on federal funding through Medicaid and Medicare reimbursement and don’t want to risk losing that vital funding. As a result, they are preemptively deciding to stop providing gender-affirming care.”
More hospitals could follow suit as they’re forced to make difficult decisions under tighter budgets, Tran said.
“This creates a concerning trend where providers may abandon evidence-based care not due to medical considerations, but due to financial pressures and regulatory uncertainty,” Tran said.
LGBTQ+ elders could also be disproportionately affected, experts said.
Medicaid is the largest funder of long-term care services in the U.S., which is especially important for LGBTQ+ seniors, who are less likely to have traditional family support systems, Tran said.
“So when you need a nursing home, when you need assisted living, when you need a home and community service and you need to pay someone for that help, it’s not going to be there because of the Medicaid cuts,” Tran said.
Beyond the specific harms to LGBTQ+ people, elected officials warned that the Medicaid cuts would inflict widespread damage on low-income families, seniors, frontline care workers and entire health systems.
U.S. Rep. Raja Krishnamoorthi said the harm caused by these cuts won’t stop at patients, and that it will threaten the financial stability of health systems. Even people with private insurance will feel the effects.
“When those hospitals close, it’s going to lead to layoffs, and that’s going to lead to a downward spiral in local economies,” Krishnamoorthi said.
Organizing to defend health care
In the face of this widespread concern, the lawmakers and advocates at the July 30 press conference vowed to fight back.
“I’ve gone toe to toe against bullies before, and I’ve won—and we’re going to win this time,” said U.S. Rep. Robin Kelly. “The fight isn’t over.”
Kelly said she had just introduced a new bill, the Protect Our Hospitals Act, which would repeal a provision in the One Big Beautiful Bill Act that cuts hospital funding and jeopardizes Medicaid services.
“It would allow states like Illinois to continue generating revenue to fund Medicaid services,” Kelly said.
Other officials said the next phase of the fight will happen at the state level, where lawmakers will soon be forced to decide which services to prioritize under reduced federal funding.
“Every Medicaid program in the country is administered by the states and then funded through a federal match,” U.S. Rep. Sean Casten said. “By cutting the match… they’re forcing every statehouse in this country to decide in the next year’s budget cycle how we are going to prioritize the needy groups that we have always thought we had a moral agency [to support].”
State Sen. Graciela Guzman said it will take a united front among local governments, health care workers and community organizers to protect Medicaid and Medicare in the months ahead.
“It will be over my body that you will cut coverage for people in our state,” Guzman said.