Medicaid Cuts Won’t Save Money—They’ll Increase Crime
Authored by Josh Hoe and Kandia Milton
Rep. Al Green (D - TX) brought national attention to the massive pending cuts to Medicaid when he stood up during President Trump’s address to Congress, shouting that Trump had, “No mandate to cut Medicaid,” which then resulted in his censure on the floor of the House of Representatives. Regardless of what you think of this action, the truth is that not only do millions of Americans rely on Medicaid for healthcare, Medicaid is one of America’s best preventative crime fighting tools and cutting Medicaid benefits to accomplish minor savings in government funding would cause major harm.
Medicaid is a federal health care program that provides comprehensive health services to low income children and adults. The program supports people with limited resources, many of whom are employed in some capacity, to ensure that they have access to mental health treatment, addiction treatment, and basic health care.
Some might say that Medicaid is safe and the President promised not to cut Medicaid, but the new budget resolution requirements passed by the Republican-majority House last week have made it impossible to find the cuts necessary without cutting Medicaid. In fact, the recent reports have found that if the congressional committee tasked with finding savings cut everything that wasn’t healthcare related, they would still be $600 billion dollars short of their target. If they want to generate the savings necessary to fund the extension of their tax-cutting agenda, they will have to cut Medicaid.
There are many reasons to support Medicaid. It enhances public health by funding preventive services–such as vaccinations and screenings–that reduce costly emergency care and hospitalizations. It also plays a pivotal role in combating the opioid crisis. Between 2015 and 2017, states that expanded Medicaid experienced a 6% reduction in opioid overdose deaths, attributed to increased access to medication-assisted treatments like buprenorphine and methadone. Medicaid expansion has also been associated with a 9.7% decrease in opioid-related inpatient hospitalizations, alleviating the burden on healthcare facilities and lowering overall healthcare costs.
But perhaps most importantly, Medicaid prevents crime, specifically drug related crime. Research done by the National Library of Medicine suggests that the creation of care “creates new avenues for individuals to…receive treatment, and avoid criminalization” and that expanded Medicaid “reduced [drug-related] police arrests.” While another study found that Medicaid expansion increased access to substance use disorder treatment which also resulted in crime-prevention.
The impacts of this prevention can be felt across crime categories and should be considered “an important offset to the government's cost burden for the ACA Medicaid expansion.” But unfortunately, many of the people involved in making these decisions only see Medicaid as a handout or social giveaway. In fact, cutting Medicaid in Tennessee, for example, resulted in an increase in crime.
Public safety has always been a bipartisan issue. In 2024, about 58% of American adults believed that reducing crime should be a top priority, up from 47% at the beginning of Joe Biden’s presidency. While polling lists crime as a slightly higher priority for Republicans, data shows that concerns about crime have been increasing for both Republicans and Democrats since 2021. Whether the perception of crime rising or falling is accurate or not, way too many people identify as victims of crime. If it is important to find savings, we should remain committed to taking advantage of cost-effective ways to reduce crime and protect our communities, without solely depending on locking people up.
GOP loyalists will say that the party’s plan is not to cut Medicaid, but rather to include a set of work requirements into Medicaid. However, Medicaid work requirements can actually cause working people to lose coverage. In my home state of Michigan, 69% of Michiganders said that they did better at work after Medicaid was expanded and many who were out of work said Medicaid made it easier for them to seek out work. While the GOP’s plan might save some money, even the government’s own numbers suggest that cuts would reduce or end federal coverage for over 1.5 million Americans.
We should be doing everything that we can to keep people safe, prevent vulnerable people from turning to crime, and provide resources for people with mental health issues. One of the cheapest and most effective ways to prevent crime is to provide people with the health care, mental health treatment, and substance abuse treatment that they need. Cutting Medicaid would make crime more likely and be a disservice to public safety.
