The Hidden Cost of Cutting Medicaid

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Medicaid was never intended to be the backbone of the U.S. public health system. But what started in 1965 as a limited health insurance option for a small group of low-income Americans has grown into a $900 billion program that funds everything from hospital care to housing support. In this episode, Michael Sparer and Rebecca Sale trace the history of Medicaid and unpack the sweeping changes coming to the program under the “One Big Beautiful Bill.” The result won’t just be fewer people with insurance. It could also mean unexpected and harmful cuts to the country’s already fragile public health system. They also discuss whether a small, unexpected provision for rural health investment could…