Skip to content
Search

Latest Stories

Top Stories

Musk budget cuts will leave millions uninsured

Musk  budget cuts will leave millions uninsured

Female doctor and senior woman looking at digital tablet in exam room

Getty Images//Stock Photo

As Donald Trump begins his second term, America’s healthcare system is in crisis: medical costs are skyrocketing, life expectancy has stagnated, and burnout runs rampant among healthcare workers.

These problems are likely to become worse now that Trump has handed the job of cutting the federal budget over to Elon Musk. He will lead the newly formed Department of Government Efficiency (DOGE), a non-government entity tasked with slashing $500 billion in “wasteful” spending.


The harsh reality is that the mission can’t succeed without gutting healthcare access and coverage for millions of Americans.

Deleting dollars from American healthcare

Since Trump’s first term, the country’s economic outlook has worsened significantly. In 2016, the national debt was $19 trillion, with $430 billion allocated to annual interest payments. By 2024, the debt had nearly doubled to $36 trillion, requiring $882 billion in debt service—12% of federal spending that is legally untouchable.

Add to that another 50% of government expenditures that Trump has deemed politically off-limits: Social Security ($1.35 trillion), Medicare ($848 billion) and Defense ($1.13 trillion). That leaves just $2.6 trillion—less than 40% of the $6.75 trillion federal budget—available for cuts.

With Medicare off limits to DOGE, the options for major reductions are extremely limited. Big-ticket healthcare items like the $300 billion in tax-deductibility for employer-sponsored health insurance and $120 billion in expired health programs for veterans will prove politically untouchable. One will raise taxes for 160 million working families, and the latter will leave veterans without essential medical care.

This shortfall will require Musk and DOGE to cut billions in government healthcare spending. But where will they find it?

In a recent op-ed, Musk and Vivek Ramaswamy proposed eliminating expired or misused funds for programs like Public Broadcasting and Planned Parenthood, but these examples account for less than $3 billion total—not even 1% of their target.

If significant reductions in cost are to be realized, DOGE will have to attack Medicaid and the ACA health. Here’s how 20 million people will likely lose coverage as a result, assuming this level of deficit savings is achieved:

1. Reduced ACA exchange funding

Since its enactment in 2010, the Affordable Care Act (ACA) has provided premium subsidies to Americans earning 100% to 400% of the federal poverty level. For lower-income families, the ACA also offers Cost Sharing Reductions, which help offset deductibles and co-payments that fund 30% of total medical costs per enrollee. Without CSRs, a family of four earning $40,000 could face deductibles as high as $5,000 before their insurance benefits apply.

If Congress allows CSR payments to expire in 2026, federal spending would decrease by approximately $35 billion annually. If that happens, the Congressional Budget Office expects 7 million individuals to drop out of the exchanges. Worse, without affordable coverage alternatives, 4 million families would lose their health insurance altogether.

2. Slashing Medicaid coverage and tightening eligibility

Medicaid currently provides healthcare for over 90 million low-income Americans, including children, seniors, and individuals with disabilities. To meet DOGE’s $500 billion goal, several cost-cutting strategies appear likely:

· Reversing Medicaid expansion: The ACA expanded Medicaid eligibility to those earning up to 138% of the federal poverty level, reducing the uninsured rate from 16% to 8%. Undoing this expansion would strip coverage from millions in the 40 states that adopted the program.

· Imposing work requirements: Proponents argue this could encourage employment, but most Medicaid recipients already work for employers that don’t provide insurance. In reality, work requirements primarily create bureaucratic barriers that disqualify millions of eligible individuals, reducing program costs at the expense of coverage.

· Switching to block grants: Unlike the current Medicaid system, which adjusts funding based on need, less-expensive block grants would provide states with fixed allocations. This will, however, force them to cut services and reduce enrollment.

Medicaid currently costs $800 billion annually, with the federal government covering 70%. Reducing enrollment by 10% (9 million people) could save over $50 billion annually, while a 20% reduction (18 million people) could save $100 billion.

Either outcome would devastate families by eliminating access to vital services, including prenatal care, vaccinations, chronic disease management, and nursing home care. As states are forced to absorb the financial burden, they’ll likely cut education budgets and reduce infrastructure investments.

The first 100 days

The numbers don’t lie: Musk and DOGE could slash Medicaid funding and ACA subsidies to achieve much of their $500 billion target. But the human cost of this approach would be staggering.

Fortunately, there are alternative solutions that would reduce spending without sacrificing quality. Shifting provider payments in ways that reward better outcomes rather than higher volumes, capping drug prices at levels comparable to peer nations, and leveraging generative AI to improve chronic disease management could all drive down costs while preserving access to care.

These strategies address the root causes of high medical spending, including chronic diseases that, if better managed, could prevent 30-50% of heart attacks, strokes, cancers, and kidney failures, according to CDC estimates.

Whether Musk and DOGE will consider the kinds of reform options I have suggested in their pursuit of immediate budgetary cuts remains to be seen.

If they choose not to, the health of millions of Americans is at major risk.

Robert Pearl, the author of “ ChatGPT, MD,” teaches at both the Stanford University School of Medicine and the Stanford Graduate School of Business. He is a former CEO of The Permanente Medical Group.

Read More

Support for International Students’ Mental Health Fails As Federal Visa Revocations Rise

holding hands

Support for International Students’ Mental Health Fails As Federal Visa Revocations Rise

The University of Washington’s international student population is raising concerns about the lack of mental health support provided to them by International Student Services, particularly in the context of visa revocations.

“I've personally sacrificed so much to get to UW,” first-year Kaira Wullur said. “I know my parents have also sacrificed so much. It is super draining to think that what I've been working towards could be stripped away from people who don't even know who I am.”

Keep ReadingShow less
Iran Warns ‘The Battle Begins’—What Role Will Trump Have the U.S. Play?

artistic animated picture of Donald Trump

Iran Warns ‘The Battle Begins’—What Role Will Trump Have the U.S. Play?

The sixth day of escalating tensions between Iran and Israel saw a stark warning from Iran’s Supreme Leader Ayatollah Ali Khamenei, who declared on social media: “The battle begins.” This came shortly after President Donald Trump referred to Khamenei as an “easy target” and stated that America’s “patience is wearing thin,” demanding Iran’s “unconditional surrender.”

The president cut short his trip at the Group of Seven summit in Canada, citing the ongoing conflict between Israel and Iran.

Keep ReadingShow less
Beyond the Game: Pioneering Women’s Healthcare in Collegiate Athletics

Olympic Trials

Beyond the Game: Pioneering Women’s Healthcare in Collegiate Athletics

For decades, collegiate sports have served as a powerful platform for achievement, community, and identity. But amid the victories and records, a quieter struggle persists—one rooted in systemic neglect of women's unique health needs. While gender disparities have garnered increasing attention across society, the gap in sports medicine remains pronounced. Less than 2%of federally allocated research funding targets reproductive health and related issues, leaving many female athletes without the tailored support necessary to thrive.

Recognizing this gap, the University of Washington has begun pioneering initiatives to address women’s healthcare needs in collegiate athletics, emphasizing a holistic, research-informed approach. These efforts aim not only to improve individual athlete outcomes but also to set a precedent for other institutions seeking to foster gender equity in sports medicine.

Keep ReadingShow less
Navigating the Medical Maze: It’s Hard Enough With Full Health Coverage

A doctor treating a patient in a hospital.

Getty Images, Bevan Goldswain

Navigating the Medical Maze: It’s Hard Enough With Full Health Coverage

The woman on the phone from the Mayo Clinic was growing exasperated as she ran through how to sweep up my medical records.

“So, you got the CT scan in Storm Lake? And the hormone therapy in Spencer? And the MRI at Mercy and biopsy someplace else in Sioux City? And a PET scan at June Nylen Cancer Center in Sioux City? And what at Iowa City? And California? Where?”

Keep ReadingShow less