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For Heather Heisler, the stakes are high. Her husband has been on Medicaid for years.<\/p>\n
\u201cWe\u2019re ranchers, and there\u2019s not much money in ranching,\u201d said Heisler, who gets her own health care from the Indian Health Service. \u201cMost people think there is, but there isn\u2019t.\u201d<\/p>\n
Heisler was selling handicrafts outside the old county jail in Globe on a recent Friday night when the town hosted a downtown street fair with food trucks and live music.<\/p>\n
She said Medicaid was especially helpful after her husband had an accident on the ranch. A forklift tipped over, and he had to have part of his left foot amputated. \u201cIf anything happens, he\u2019s able to go to the doctor,\u201d she said. \u201cGo to the emergency room, get medicines.\u201d<\/p>\n
She shook her head when asked what would happen if he lost the coverage. \u201cIt would be very bad for him,\u201d she said.<\/p>\n
Among other things, proposed tax legislation written by House Republicans would require working-age Medicaid enrollees to prove they are employed or seeking work. The bill, which passed the House and has advanced to the Senate, would also mandate more paperwork from people to prove they\u2019re eligible.<\/p>\n
Difficult applications can dissuade many people from enrolling in Medicaid, even if they\u2019re eligible, researchers have found<\/a>. And the nonpartisan Congressional Budget Office estimates<\/a> more than 10 million people will likely lose Medicaid and CHIP insurance under the House Republican plan.<\/p>\n That would reverse big gains made possible by the 2010 Affordable Care Act, which has allowed millions of low-income, working-age adults in places like Globe to get health insurance.<\/p>\n Nationally, Medicaid and CHIP have expanded dramatically over the past two decades, with enrollment in the programs surging from about 56 million<\/a> in 2005 to more than 78 million<\/a> last year, according to federal data.<\/p>\n \u201cMedicaid has always played an important role,\u201d said Joan Alker, who runs the Georgetown University Center for Children and Families. \u201cBut its role has only grown over the last couple of decades. It really stepped in to address many of the shortcomings in our health care system.\u201d<\/p>\n That\u2019s particularly true in rural areas, where the share of people with disabilities<\/a> is higher, residents have lower incomes, and communities are reliant on industries with skimpier health benefits such as agriculture and retail.<\/p>\n In Globe, former mayor Fernando Shipley said he\u2019s seen this firsthand.<\/p>\n \u201cA lot of people think, \u2018Oh, those are the people that aren\u2019t working.\u2019 Not necessarily,\u201d said Shipley, who operates a State Farm office across the road from the rusted remains of the Old Dominion copper mine. \u201cIf you\u2019re a single parent with two kids and you\u2019re making $20 an hour,\u201d he added, \u201cyou\u2019re not making ends meet. You\u2019ve got to pay rent; you\u2019ve got to feed those kids.\u201d<\/p>\n Not far away, at the local hospital, some low-wage workers at the registration desk and in housekeeping get health care through Medicaid, chief financial officer Harold Dupper said. \u201cAs much as you\u2019d like to pay everyone $75,000 or $80,000 a year, the hospital couldn\u2019t stay in business if that was the payroll,\u201d he said, noting the financial challenges faced by rural hospitals.<\/p>\n The growing importance of Medicaid in places like Globe helps explain why Republican efforts to cut the program face so much resistance, even among conservatives.<\/p>\n \u201cThere\u2019s been a shift in the public\u2019s attitude, and particularly voters on the right, that sometimes government plays a role in getting people health care. And that\u2019s OK,\u201d said pollster Bob Ward. \u201cAnd if you take away that health care, people are going to be angry.\u201d Ward\u2019s Washington, D.C., firm, Fabrizio Ward, works for Trump. He also polls for a coalition trying to protect Medicaid.<\/p>\n At the same time, many of the communities where Medicaid has become more vital in recent years remain very conservative politically.<\/p>\n More than two-thirds of nearly 300 U.S. counties with the biggest growth in Medicaid and CHIP since 2008 backed Trump in the last election, according to a KFF Health News analysis of voting results and enrollment data from Georgetown. Many of these counties are in deep-red states such as Kentucky, Louisiana, and Montana.<\/p>\n Voters in places like these are more likely to be concerned about government waste, polls show. In one recent national survey<\/a>, 75% of Republicans said they think waste, fraud, and abuse in Medicaid is a major problem.<\/p>\n The actual scale of that waste is hotly debated, though many analysts believe<\/a> relatively few enrollees are abusing the program.<\/p>\n Nevertheless, around Globe, Republican arguments that cuts will streamline Medicaid seemed to resonate.<\/p>\n Retiree Rick Uhl was stacking chairs and helping clean up after lunch at the senior center. \u201cThere\u2019s a lot of waste, of money not being accounted for,\u201d Uhl said. \u201cI think that\u2019s a shame.\u201d Uhl said he\u2019s been saddened by the political rancor, but he said he\u2019s encouraged by the Trump administration\u2019s aggressive efforts to cut government spending.<\/p>\n Back at the street fair downtown, David Sander, who is also retired, said he doubted Medicaid would really be trimmed at all.<\/p>\n \u201cI\u2019ve heard that they really aren\u2019t cutting it,\u201d Sander said. \u201cThat\u2019s my understanding.\u201d<\/p>\n Sander and his wife, Linda, were tending a stall selling embroidery that Linda makes. They also have a neighbor on Medicaid.<\/p>\n \u201cShe wouldn\u2019t be able to live without it,\u201d Linda Sander said. \u201cCouldn\u2019t afford to have an apartment, make her bills and survive.\u201d<\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\n![](\"https:\/\/qopreliz.com\/wp-content\/uploads\/2025\/05\/Arizona-Medicaid-02-scaled.jpg\")
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