U.S. House Speaker Kevin McCarthy, a California Republican, speaks with reporters about the debt limit and government funding negotiations outside the Capitol on Thursday, May 25, 2023. (Jennifer Shutt/States Newsroom)

Health care continues to be too expensive for far too many people in our commonwealth.? Medical bills are a leading cause of debt in Kentucky and many families are already making difficult sacrifices during these uncertain economic times. Making matters worse, there is a dangerous effort underway in Washington, D.C. that puts tens of millions of people at risk of losing their health insurance.

Instead of paying for the programs and resources Congress already agreed to provide to us, House Speaker Kevin McCarthy went to Wall Street to deliver the message that he would protect corporate interests at the expense of working families. And he’s doing just that by threatening to hold our economy hostage if cuts to vital programs like Medicaid aren’t made.

These cuts wouldn’t impact everyone equally. People with chronic health conditions, rural Kentuckians, and households with the lowest incomes have the most to lose. Children are also at risk of losing coverage if efforts to cut Medicaid succeed. Due to longstanding and discriminatory policies in our country, communities of color would be hit hardest, deepening inequity and limiting economic mobility for those that already face the largest barriers to care.

The proposed cuts would put health insurance coverage on the chopping block for 574,000 Kentuckians, putting their health and their livelihoods at risk. Only one state — Arkansas —? ever implemented a similar policy and the immediate effects were clear. Nearly one? in four enrolled adults lost health coverage before the requirements were vacated by a court. There continues to be no evidence the effort increased employment or achieved what policymakers said it would.

This shouldn’t be acceptable. There is no evidence that adding more bureaucratic hurdles for people to get affordable health care works. In fact, Medicaid is a program that helps keep people with low-wage jobs healthy enough to work. Threatening that care is counterproductive.

Expanded access to affordable health care, including Medicaid, is one of the most impactful ways to support our families, improve our workforce and keep our economy strong. It’s a popular program that currently provides health coverage to 1.7 million people in Kentucky, including more than 600,000 children, people with disabilities and low-income workers who aren’t offered affordable coverage in jobs like daycare, retail, food service, construction and other essential work that keeps our economy running.

Many Kentucky families are struggling right now. And with inflation and rising costs of groceries, it’s a particularly dangerous time to start restricting programs like SNAP and Medicaid that low-income Kentuckians rely on to care for their families. Having enough income to meet basic needs and put nutritious food on the table are just as essential to our health as access to care. Proposals that take away people’s health coverage, food or housing by adding bureaucratic reporting requirements only exacerbate poor health.

No one should have to exhaust their life savings or lose their home just because they got sick. These proposed cuts would lead to more long-term costs, more uninsured families and more debt. Taking away health care from Kentuckians cannot be a political bargaining chip. And we need our state and federal lawmakers to listen to their constituents to improve coverage and care, not take it away or make it more difficult to obtain.

To protect Kentucky from detrimental health impacts, President Biden and congressional leaders must reject any proposals that take away vital services and income support from the people who count on it to meet their basic needs.?

Delilah Jenkins, 6, rests outside her camper last November at Camp Graves where she and her family were living in transitional housing after losing everything in the December 2021 tornado. Affordable housing is among Kentucky's many needs. (Julia Rendleman for the Kentucky Lantern)

When is a tax cut NOT a tax cut? When a permanent reduction in state revenue is based on a temporary surplus in the state budget. The result is an unsustainable situation — a tax cut that ends up raising taxes elsewhere and harms our ability to fund the vital programs that keep Kentuckians healthy and thriving.

Right now state budgets across the country are full as a result of emergency pandemic programs and stimulus packages like the American Rescue Plan Act (ARPA). But these measures are temporary, with most expiring in 2023. Instead of using this money to build a commonwealth where everyone can live a healthy life and contribute to the health of their communities, some lawmakers have decided to squander the opportunity.

House Bill 8, passed last year, bases permanent income tax cuts on this temporary money. The first tax cut went into effect on Jan. 1 and legislators are already poised to pass another one. These moves take money away from the people who need it, just to give it away to the wealthiest among us. The result is already driving up prices on everyday services because of the new sales taxes.

Now, House Bill 1 puts into motion phase two of this plan to turn federal relief dollars into big tax cuts for the wealthy.

These cuts don’t just drive up the cost of basic necessities, they risk creating shortfalls in the state budget that will threaten Kentucky’s ability to keep up essential public services. They could threaten funding for expanded Medicaid for more than half a million hardworking Kentuckians and low-income families who don’t earn enough to afford health insurance. Cuts in Medicaid reduce funding for rural hospitals, many of which are already struggling to keep their doors open and find quality staff.

These cuts come at a time when Kentucky is already facing crises across multiple fronts — a nursing shortage, a mental health-care shortage, a teacher shortage, a childcare shortage, an affordable housing shortage. Meanwhile, thousands of our most vulnerable children and adults with disabilities remain on years-long waiting lists for the Home and Community-based Services they need to live and thrive in their communities.

Kentucky has been under-investing in essential services for too long and it’s starting to catch up with us.

These past few years Kentucky has seen tremendous resiliency, but also tremendous need. The pandemic has pushed our health-care system to its limits. Western Kentucky is rebuilding from tornados while Eastern Kentucky is rebuilding from flooding. Many families went without power over the Christmas holiday, not because of felled power lines but because public utility infrastructure couldn’t keep up with demand. We don’t know where the next disaster will come, but we know it will come. We need to make sure we’re prepared.

A better Kentucky is possible. Instead of another tax break for the top, it’s time for Kentucky to invest in itself. We can make sure our commonwealth has resources ready and available for everyone. We have the resources to keep our children fed, housed and cared for. We have the resources to keep our rural hospitals open and accessible. We have the resources to cover low-wage workers and families through Medicaid, which has proven to be one of Kentucky’s best investments in itself, its economy and its workforce.

Yet we won’t have the resources to do any of that if we squander this surplus.

Continued cuts will dig a financial hole many of Kentucky’s school, hospitals, and other essential services may never escape. It’s a move that benefits most those who need it least, and the end result is a “tax cut” that many hardworking Kentuckians will end up paying for, in 2023 and beyond.