Editor’s note: CHN sent the letter below on May 13, 2025 to the U.S. House of Representatives asking Members to vote “No” on the Energy and Commerce Committee reconciliation text.

Dear Representative:

The Coalition on Human Needs strongly urge you to vote NO on the reconciliation text before the Energy and Commerce Committee today.

The Coalition on Human Needs is made up of human service providers, faith groups, policy experts, and civil rights, labor, and other organizations concerned with meeting the needs of people with low incomes. We are concerned about the overall budget reconciliation package, which makes deep cuts to basic needs programs and will take assistance away from people with low incomes, seeking harsh reductions in nutrition, Medicaid and other health care, education and other human needs programs.

The House Energy and Commerce proposal will cut $715 billion from Medicaid, the largest cut to Medicaid in history, as part of a budget package that guts basic needs programs. Early estimates from the nonpartisan Congressional Budget Office show nearly 14 million are at risk of losing health care coverage, with the majority of those losing Medicaid coverage.

Medicaid is not just a line item in a budget ― it’s a lifeline for millions of people and families. Medicaid is critical to the well-being of older adults, children, people with disabilities, family caregivers, care workers, and families in EVERY community and each Congressional District. This will have a substantial impact on the health system as a whole, and these cuts could lead to a loss of jobs in your state. The harsh cuts proposed for Medicaid will put local health care providers at risk and force rural hospitals and nursing homes to close, shutter drug treatment programs and reduce access to mental health services, and make it harder for everyone to access the health care they need.

We know that the cuts and paperwork requirements proposed will deny health care to people who need it. CHN strongly opposes penalizing people facing job losses by taking away Medicaid through harsh work reporting requirements that ensnarl people in bureaucratic red tape — taking away Medicaid’s health services does not help people find jobs and instead makes it more difficult for people to find work, especially in a tough economy. In addition, people with conditions like severe pain, fatigue, or mental illness may not qualify as ‘disabled enough’ to be exempted from these new work requirements. Many families are being squeezed by rising prices — and this gets worse if we unexpectedly fall on tough times. When families face economic reverses, smart, targeted support can keep people in their homes, children fed and in school, disabled veterans cared for, and workers on the job.

Evidence shows that millions of eligible Medicaid participants, including children and people with disabilities, could lose coverage with complicated and frequent eligibility checks along with other paperwork requirements. A recent analysis by Kaiser Family Foundation found that nearly 70% of people who lost Medicaid between April 2023 and September 2024 were terminated for procedural reasons alone—most often due to missed paperwork. Additionally, research from the HHS Assistant Secretary for Planning and Evaluation shows that, based on pre-pandemic data, 72% of children dropped from Medicaid during redeterminations were actually eligible for coverage.

We also have deep concerns about the impact of new budget proposals on state budgets, including the ripple effect on “optional” services that allow seniors and people with disabilities to live with dignity and independence in their own homes (more on the evidence that Medicaid cuts impact Home and Community Based Services). We also oppose cutting Medicaid matching funds for 14 states that cover undocumented immigrants with their own taxpayer dollars in an attempt to coerce them to stop their health coverage programs. We urge you to reject any attacks on health coverage or other basic needs programs that shift costs to the states – including potential amendments that attack health coverage for very low-income adults covered through the Affordable Care Act expansion.

The large loss of health coverage comes from massive cuts to Medicaid combined with failing to extend expiring Affordable Care Act marketplace premium credits. This will increase premium costs for people with private insurance. We also oppose ending ACA and Medicare eligibility for many lawfully present, taxpaying immigrants in this proposal. We all want a more efficient government. But cutting the heart out of basic needs programs including Medicaid doesn’t eliminate fraud — it creates bigger problems down the road, shifting the burden to service providers, local governments, and taxpayers, and will lead to higher costs and more strain on American taxpayers.

Many in our networks are concerned about rising costs—and with the combination of uncertainty with tariffs and deep cuts to food assistance and health care, we worry that many more families will struggle to make ends meet, facing the loss of jobs, rising prices, and signs of economic downturn. Families are frightened they will lose their ability to feed their children through deep cuts to SNAP in the Agriculture Committee, while deep cuts in the Education and Workforce Committee could put higher education out of reach for them because they will lose financial assistance. These cuts to Medicaid and other basic needs programs will be used partly for border enforcement, detention and deportation of immigrants, many of whom have legal status the Trump Administration is now attempting to overturn. These new policies are wasteful, inhumane, and destructive to our communities and economy. In other words, families will feel the combined impact of cuts to Medicaid and other health assistance along with other basic needs programs – making the combined budget package even more reckless.

And we note that millions of people with low incomes will lose access to basic needs programs all to give tax breaks to the wealthy and corporations. We cannot keep allowing the passage of these unfair tax policies that disproportionately benefit the wealthy while making low-income and vulnerable communities suffer, including by taking health care away from millions. That’s not good for our society or economy. Now more than ever, it’s critical that Congress protect health care, nutrition, and other essential services that help millions of families meet their basic needs. We should strengthen support for these programs — not taking them away.

A vote for the Energy and Commerce reconciliation bill is a vote for extreme and damaging cuts to Medicaid and other health assistance, inflicting unprecedented harms. We strongly urge you to vote no on the proposal before you in committee today.