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Miami Herald
4 days ago
- Business
- Miami Herald
Changes to federal student loans leave aspiring medical students scrambling to cover costs
CHICAGO - Twenty-year-old Eric Mun didn't want to believe it: Only one kid in the family could make it to medical school - and it wasn't going to be him. Mun had done everything right. He graduated high school with honors, earned a scholarship at Northwestern University and breezed through his biology courses. He immigrated to Alabama from Korea as a toddler. From the quiet stretches of the South, he dreamed of helping patients in a pressed white coat. But dreams don't pay tuition. And with new borrowing limits, Mun's family can only support one child through school. "My parents already implied that my older brother is probably going to be the one that gets to go," Mun said. President Donald Trump's sweeping "big, beautiful" tax and spending bill, signed into law earlier this month, imposes strict new caps on federal student loans, capping borrowing for professional schools at $50,000 per year. The measure particularly affects medical students, whose tuition often exceeds $300,000 over four years. Aspiring physicians like Mun have been thrown into financial uncertainty. Many members of the medical community say the measures will send shock waves through a system already laden with economic barriers, discouraging low-income students from pursuing a medical degree. "It might mean there are people who want to be doctors that can't be doctors because they can't afford it," said Richard Anderson, president of the Illinois State Medical Society. Before the passage of Trump's budget bill, the Grad PLUS loan program allowed graduate students to borrow their institution's total cost of attendance, including living expenses. The program was slashed as part of a broader overhaul to the federal student loan system. Now, beginning July 1, 2026, most graduate students will be capped at $20,500 in federal loans per year, with a total limit of $100,000. Students in professional schools, like medical, dental or law school, will face the $50,000 annual cap and a total limit of $200,000. Mun's parents work at an automobile assembly plant. Throughout high school, he knew he would have to rely on scholarships and federal loans to pay his way through college. Mun's voice faltered. "I'm just trying to remain hopeful," Mun said. Also folded into the bill: the elimination of several Biden-era repayment plans, cuts to Pell Grants and limits to the Parent PLUS loans program, which allows parents of dependent undergraduates to borrow. Proponents of the Republican-backed bill said the curbed borrowing will incentivize medical schools and other graduate programs to lower tuition. The tuition of most Chicago-area medical schools is nearly $300,000 for four years, not including cost-of-living expenses. Northwestern University's Feinberg School of Medicine has a $465,000 price tag after accounting for those indirect costs, according to the school's website. Rosalind Franklin University of Medicine and Science trails closely behind at nearly $464,000. "One of the main concerns about the Grad PLUS program is money that is going to subsidize institutions rather than extending access to students," said Lesley Turner, an associate professor at the University of Chicago Harris School of Public Policy. Still, many medical professionals expressed doubt that schools will adjust their costs in response to the bill. Tuition for both private and public schools has been steadily climbing for decades, up 81% from 2001 after adjusting for inflation, according to the Association of American Medical Colleges. There's some evidence that Grad PLUS may have contributed to those tuition hikes. A study co-authored by Turner in 2023 found that prices increased 65 cents per dollar after the program's introduction in 2006. There was also little indication that Grad PLUS had fulfilled its intended goal of expanding access to underrepresented students. But Turner cautioned against the abrupt reversal of the program. After accounting for inflation, the lifetime borrowing limits now placed on graduate students are lower than they were in 2005, she said. Many students may turn to private loans to cover the gap, often at higher interest rates. More than half of medical students relied on Grad PLUS loans, according to AAMC. The median education debt for indebted medical students is around $200,000, with most repayment plans lasting 10 to 20 years. The median stipend for doctors' first year post-MD was just $65,100 in 2024. "I think for many reasons, it would have been reasonable to put some sort of limit on Grad PLUS loans, but I think this is a very blunt way of doing it," Turner said. In a high-rise on Northwestern's downtown campus this month, 20 undergraduate students and alums from local colleges gathered for the Chicago Cancer Health Equity Collaborative Fellows program. The eight-week summer intensive offers aspiring medical professionals a deep dive into cancer health disparities information and research. Participants like Mun have been left reeling after the flurry of federal cuts. Alexis Chappel, a 28-year-old graduate of Northeastern Illinois University, watched her dad struggle with addiction growing up. She was deeply moved by the doctors who supported his recovery, and it inspired her to pursue medicine. But she has no idea how she'll cover tuition. "I feel like it's in God's hands at this point," Chappel said. "I just felt like it's a direct attack on Black and brown students who plan on going to medical school." Just 10% of medical students are Black and 12% are Latino, according to AAMC enrollment data. Socioeconomic diversity is also limited: A 2018 analysis found that 24% of students came from the wealthiest 5% of U.S. households. Tricia Pendergrast, who graduated from Feinberg in 2023, relied entirely on Grad PLUS loans to fund her medical education. Juggling classes and clinicals, she had little money saved and no steady stream of income. Pendergrast was so strapped for cash that she enrolled in SNAP benefits - a program also cut under Trump's budget bill. Now an anesthesiologist at University of Michigan Health, she's documented her concerns on TikTok for her 48,000 followers. "It's not going to improve representation, and it's not going to improve access," Pendergrast said. "It's going to act as a deterrent for people who otherwise would be excellent physicians." For low-income students, the application process is already fraught with economic obstacles, Pendergrast said. Metrics like GPA and the Medical College Admissions Test, or MCAT, are heavily weighted in admissions, and may disadvantage students from underresourced schools. Many students also lack mentorships or networks to guide them through the process, she noted. "I think the average medical student is going to be richer and whiter, and not from rural areas and not from underserved communities," Pendergrast said. The elimination of Grad PLUS loans comes amid a mounting nationwide physician shortage. A recent AAMC report predicted a shortfall of 86,000 physicians by 2036. Meanwhile, a significant portion of the workforce is poised to enter retirement: The U.S. population aged 65 and older is expected to grow 34.1% over the next decade. The shortage is particularly concentrated in primary care. In practice, that means longer waiting times for patients, and an increased caseload on physicians, who may already suffer from burnout. "If the goal is truly to make America healthy again, then we need to have a strong physician workforce … We should be coming up with ideas to make it more accessible for people who want to be doctors as opposed to hindering that," Anderson said. Sophia Tully, co-president of the Minority Association of Pre-Med Students at Northwestern, said she and her peers have struggled to reconcile with a system that often feels stacked against them. The 21-year-old plans on taking an extra gap year before medical school in an effort to save money. Tully summed up the environment on campus: "For lack of a better word, people are panicking." Copyright (C) 2025, Tribune Content Agency, LLC. Portions copyrighted by the respective providers.
The Intercept
6 days ago
- Politics
- The Intercept
Is AIPAC Testing the Waters to Primary Rep. Summer Lee?
Pro-Israel groups are considering backing two potential primary challengers against progressive Rep. Summer Lee, D-Pa. A survey sent earlier this month to people living in Pittsburgh and its suburbs asked for respondents' opinion on two possible candidates to challenge Lee. The survey included a question on people's opinions about the candidates being backed by 'a right-wing organization that supports Trump and is funded by MAGA millionaires and billionaires.' The survey question appears set up to test whether voters would oppose one of the candidates because of backing from groups like the American Israel Public Affairs Committee — which is funded by billionaire donors to Donald Trump and, in 2020, endorsed more than 100 Republican members of Congress who voted to overturn the results of that year's presidential election. The wording was identical to another survey sent in May to constituents in the district of Rep. Ilhan Omar, D-Minn., The Intercept reported. That survey was the first this year to indicate that AIPAC was considering a primary challenge against Omar. With the latest poll, it appears that AIPAC and possibly other pro-Israel groups are setting their sights on another challenge against Lee. 'As usual, AIPAC sees the Democratic electorate begging for more progressive leadership that takes on the corporate elite, and they are desperate to force corporate shills down our throats instead,' said Usamah Andrabi, the communications director for Justice Democrats, a group backing Lee. (AIPAC did not respond to a request for comment.) The survey in Lee's district also said both potential candidates, Pittsburgh City Controller Rachael Heisler and former Pennsylvania Auditor General Eugene DePasquale, were backed by 'pro-Israel groups that lobby Congress to provide billions of U.S. taxpayer dollars in aid and weapons to Israel each year.' Lee and Omar are two of a handful of progressive members of Congress who have drawn the ire of AIPAC and other pro-Israel groups for calling to end U.S. military funding to Israel and criticizing Israel's genocide in Gaza. AIPAC spent more than $100 million on primaries last cycle, including more than $25 million to unseat Reps. Cori Bush, D-Mo., and Jamaal Bowman, D-N.Y. Lee, Omar, and other progressives have also been vocal critics of AIPAC. Lee introduced a bill earlier this year to ban super PACs like AIPAC's United Democracy Project, which spent millions of dollars against her when she first ran for Congress in 2022. Lee won reelection last year against another Republican-backed pro-Israel primary challenger. In that race, The Intercept reported. AIPAC tried and failed to recruit two candidates to run against her. 'Every cycle, corporate lobbies, special interest groups and Trump megadonors look to buy this Congressional seat,' Lee said in a statement. 'My constituents want leaders who fight for their interests against the wealthy & well-connected, not politicians that can be bought with a corporate PAC check.' The survey asked a series of questions about positions taken by candidates that aligned more closely with Republicans than liberal Democrats. 'It's no mistake that they're polling the viability of candidates that evidently oppose the Affordable Care Act, Medicare for All, same-sex marriage, the Green New Deal, abortion rights, Medicare, and Social Security,' said Andrabi. 'AIPAC's favorite type of Democrat is one you can most easily mistake for a Republican and most easily.' The survey in Pittsburgh asked people to rate their level of concern in response to pro-Israel groups supporting both Heisler and DePasquale, and whether they would support either candidate in a Democratic primary election against Lee. 'Rachael Heisler is supported by pro-Israel groups that lobby Congress to provide billions of U.S. taxpayer dollars in aid and weapons to Israel each year,' the survey said. 'Please indicate whether it raises very serious concerns, serious concerns, minor concerns, or no real concerns for you about Rachael Heisler.' The survey posed the same question about DePasquale. The poll also asked respondents to rate their level of concern about potential criticisms of Lee, DePasquale, and Heisler. Criticisms of Lee included her vote against former President Joe Biden's debt deal, her support for the Uncommitted movement in 2024, and the claim that 'Lee is more interested in dividing Democrats' than fighting Trump's agenda. 'Summer Lee is too extreme,' read another prompt. 'She has long associated herself with the Democratic Socialists of America which supports defunding the police, eliminating prisons and releasing all criminals, opening our borders, getting rid of individually-owned cars, abolishing U-S-A-I-D, and withdrawing from NATO. Summer Lee's radical positions do not reflect our community.' (Lee is no longer a member of DSA.) Respondents were asked to rate their concerns about the statement. In a section asking about possible criticism of DePasquale, the survey asked respondents how they felt about him taking corporate PAC money and opposing progressive policy efforts like Medicare for All and the Green New Deal. Read our complete coverage 'While progressive Democrats have called for getting corporate money out of politics, Eugene DePasquale has taken tens of thousands of dollars from corporate PACs, including from major corporations like AT&T, Comcast, Pfizer and PNC Bank,' the survey said. It added that DePasquale 'calls himself a progressive' but opposed Medicare for All, rejected the Green New Deal, opposed same sex marriage, praised parts of Trump's agenda, and supported expanding the state's natural gas industry. (DePasquale did not respond to a request for comment.) DePasquale has supported gay marriage publicly since at least 2012. In 2020, He said he did not support the Green New Deal or Medicare for All, and favored a public option and improvements to the Affordable Care Act. On the environment, DePasquale has a mixed record. During a race for Pennsylvania attorney general and as state auditor, he came down on the side with energy interests and climate activists, respectively. Posing potential criticisms of Heisler, the survey asked respondents how concerned they were about the claim that Heisler had 'a record of standing with the wealthy and powerful' and worked with groups advancing policies to benefit billionaires, including gutting Social Security and Medicare. The survey also asked respondents how they felt about Heisler donating to the 2018 campaign of anti-abortion Democrat Dan Lipinski in Illinois. It also asked them to rate their concerns about Heisler working for former Rep. Jason Altmire, a Pennsylvania Democrat who voted against the ACA in 2010. (Heisler did not respond to a request for comment.) Respondents were also asked to rate their opinion of other officials and groups including Altmire; Rep. Alexandria Ocasio-Cortez, D-N.Y.; Democratic Socialists of America; Allegheny County Executive Sara Innamorato; Pennsylvania Gov. Josh Shapiro; and Sen. John Fetterman. Both Heisler and DePasquale have expressed support for Israel and efforts by pro-Israel groups to influence policy in Pittsburgh and Pennsylvania. DePasquale was endorsed last year by two groups that also backed Lee's primary challenger, Bhavini Patel. Earlier this year, Heisler fought a referendum petition organized by anti-genocide activists to push Pittsburgh to divest from governments engaged in genocide — namely Israel. (Not On Our Dime did not respond to a request for comment.) Last year, Heisler went on a $15,000 trip paid for by AIPAC's educational arm, which it uses to send politicians to Israel, a typical step in the group's efforts to recruit a candidate. George Latimer, the AIPAC-funded candidate who unseated Bowman, the New York representative, took a trip to Israel shortly before he announced his primary challenge. 'My constituents want leaders who fight for their interests against the wealthy and well-connected, not politicians that can be bought with a corporate PAC check,' Lee said. 'They can keep polling and we're going to keep fighting back against the Trump administration to protect and deliver for our constituents.'
Fox News
24-07-2025
- Politics
- Fox News
Noncitizen illegally voted in swing state's 2024 election, authorities say
A non-U.S. citizen in New Hampshire is being charged with illegally voting in several elections, including the 2024 presidential primary and general elections. According to a statement by the New Hampshire Department of Justice, Naseef Bryan, who was living in Manchester, New Hampshire, was arrested and is being charged with three counts of wrongful voting. He allegedly knowingly illegally voted in a local Manchester election in 2023 as well as the 2024 presidential primary and general. If convicted, he is facing between three and a half and seven years in New Hampshire State Prison and a fine of up to $4,000. He will be arraigned at the Ninth Circuit Court, Manchester District Division, in August. New Hampshire outlet NHPR reported that Bryan is a 34-year-old immigrant who, according to a legal filing, is a permanent U.S. resident from Jamaica. The outlet reported that Bryan has a lengthy history of filing over a dozen lawsuits against an array of government agencies and individuals, including a local police department, a community college in Concord and U.S. Citizenship and Immigration Services (USCIS). Bryan has previously sued USCIS twice though, according to the outlet, his grievances are unclear due to the filings being "ambiguous and contain[ing] long stretches of writing about disparate topics." NHPR wrote that in one filing against USCIS, Bryan references maritime law and requests relief in the form of gold coins. A Republican-backed law passed in 2024 requires anyone registering to vote in New Hampshire to present proof of U.S. citizenship. Though the voting bill was signed into law in September, it did not take effect until days after the 2024 presidential election, according to the New Hampshire Bulletin. Former Vice President Kamala Harris narrowly won the state of New Hampshire's four electoral college votes over President Donald Trump in a 50% to 48% vote. Republicans, however, have controlled the governor's office and both chambers of the state legislature since 2021. Bryan's arrest comes as concerns over noncitizens illegally voting are growing across the country. In Texas, state Attorney General Ken Paxton, a Republican, recently launched an investigation into more than 100 potential noncitizens who allegedly cast at least 200 ballots in the 2020 and 2022 election cycles. The majority of the suspected illegal ballots cast by potential noncitizens were in Harris County, but Paxton's office is also investigating possible instances in Guadalupe, Cameron and Eastland counties using information from the Texas secretary of state, according to a news release. The discovery was made possible by an executive order signed by Trump directing the Department of Homeland Security to provide the U.S. Citizenship and Immigration Service's SAVE Database to the states. Democratic Rep. Yvette Clarke of New York also recently raised alarms when she suggested in a resurfaced video that she needed immigrants to bolster the numbers in her district, saying, they are needed "for redistricting purposes."
Chicago Tribune
23-07-2025
- Business
- Chicago Tribune
Changes to federal student loans leave aspiring medical students scrambling to cover costs
Twenty-year-old Eric Mun didn't want to believe it: Only one kid in the family could make it to medical school — and it wasn't going to be him. Mun had done everything right. He graduated high school with honors, earned a scholarship at Northwestern University and breezed through his biology courses. He immigrated to Alabama from Korea as a toddler. From the quiet stretches of the South, he dreamed of helping patients in a pressed white coat. But dreams don't pay tuition. And with new borrowing limits, Mun's family can only support one child through school. 'My parents already implied that my older brother is probably going to be the one that gets to go,' Mun said. President Donald Trump's sweeping 'big, beautiful' tax and spending bill, signed into law earlier this month, imposes strict new caps on federal student loans, capping borrowing for professional schools at $50,000 per year. The measure particularly affects medical students, whose tuition often exceeds $300,000 over four years. Aspiring physicians like Mun have been thrown into financial uncertainty. Many members of the medical community say the measures will send shock waves through a system already laden with economic barriers, discouraging low-income students from pursuing a medical degree. 'It might mean there are people who want to be doctors that can't be doctors because they can't afford it,' said Richard Anderson, president of the Illinois State Medical Society. Before the passage of Trump's budget bill, the Grad PLUS loan program allowed graduate students to borrow their institution's total cost of attendance, including living expenses. The program was slashed as part of a broader overhaul to the federal student loan system. Now, beginning July 1, 2026, most graduate students will be capped at $20,500 in federal loans per year, with a total limit of $100,000. Students in professional schools, like medical, dental or law school, will face the $50,000 annual cap and a total limit of $200,000. Mun's parents work at an automobile assembly plant. Throughout high school, he knew he would have to rely on scholarships and federal loans to pay his way through college. Mun's voice faltered. 'I'm just trying to remain hopeful,' Mun said. Also folded into the bill: the elimination of several Biden-era repayment plans, cuts to Pell Grants and limits to the Parent PLUS loans program, which allows parents of dependent undergraduates to borrow. Proponents of the Republican-backed bill said the curbed borrowing will incentivize medical schools and other graduate programs to lower tuition. The tuition of most Chicago-area medical schools is nearly $300,000 for four years, not including cost-of-living expenses. Northwestern University's Feinberg School of Medicine has a $465,000 price tag after accounting for those indirect costs, according to the school's website. Rosalind Franklin University of Medicine and Science trails closely behind at nearly $464,000. 'One of the main concerns about the Grad PLUS program is money that is going to subsidize institutions rather than extending access to students,' said Lesley Turner, an associate professor at the University of Chicago Harris School of Public Policy. Still, many medical professionals expressed doubt that schools will adjust their costs in response to the bill. Tuition for both private and public schools has been steadily climbing for decades, up 81% from 2001 after adjusting for inflation, according to the Association of American Medical some evidence that Grad PLUS may have contributed to those tuition hikes. A study co-authored by Turner in 2023 found that prices increased 65 cents per dollar after the program's introduction in 2006. There was also little indication that Grad PLUS had fulfilled its intended goal of expanding access to underrepresented students. But Turner cautioned against the abrupt reversal of the program. After accounting for inflation, the lifetime borrowing limits now placed on graduate students are lower than they were in 2005, she said. Many students may turn to private loans to cover the gap, often at higher interest rates. More than half of medical students relied on Grad PLUS loans, according to AAMC. The median education debt for indebted medical students is around $200,000, with most repayment plans lasting 10 to 20 years. The median stipend for doctors' first year post-MD was just $65,100 in 2024. 'I think for many reasons, it would have been reasonable to put some sort of limit on Grad PLUS loans, but I think this is a very blunt way of doing it,' Turner said. In a high-rise on Northwestern's downtown campus last week, 20 undergraduate students and alums from local colleges gathered for the Chicago Cancer Health Equity Collaborative Fellows program. The eight-week summer intensive offers aspiring medical professionals a deep dive into cancer health disparities information and research. Participants like Mun have been left reeling after the flurry of federal cuts. Alexis Chappel, a 28-year-old graduate of Northeastern Illinois University, watched her dad struggle with addiction growing up. She was deeply moved by the doctors who supported his recovery, and it inspired her to pursue medicine. But she has no idea how she'll cover tuition. 'I feel like it's in God's hands at this point,' Chappel said. 'I just felt like it's a direct attack on Black and brown students who plan on going to medical school.' Just 10% of medical students are Black and 12% are Latino, according to AAMC enrollment data. Socioeconomic diversity is also limited: A 2018 analysis found that 24% of students came from the wealthiest 5% of U.S. Pendergrast, who graduated from Feinberg in 2023, relied entirely on Grad PLUS loans to fund her medical education. Juggling classes and clinicals, she had little money saved and no steady stream of income. Pendergrast was so strapped for cash that she enrolled in SNAP benefits — a program also cut under Trump's budget bill. Now an anesthesiologist at University of Michigan Health, she's documented her concerns on TikTok for her 48,000 followers. 'It's not going to improve representation, and it's not going to improve access,' Pendergrast said. 'It's going to act as a deterrent for people who otherwise would be excellent physicians.' For low-income students, the application process is already fraught with economic obstacles, Pendergrast said. Metrics like GPA and the Medical College Admissions Test, or MCAT, are heavily weighted in admissions, and may disadvantage students from underresourced schools. Many students also lack mentorships or networks to guide them through the process, she noted. 'I think the average medical student is going to be richer and whiter, and not from rural areas and not from underserved communities,' Pendergrast said. The elimination of Grad PLUS loans comes amid a mounting nationwide physician shortage. A recent AAMC report predicted a shortfall of 86,000 physicians by 2036. Meanwhile, a significant portion of the workforce is poised to enter retirement: The U.S. population aged 65 and older is expected to grow 34.1% over the next decade. The shortage is particularly concentrated in primary care. In practice, that means longer waiting times for patients, and an increased caseload on physicians, who may already suffer from burnout. 'If the goal is truly to make America healthy again, then we need to have a strong physician workforce … We should be coming up with ideas to make it more accessible for people who want to be doctors as opposed to hindering that,' Anderson said. Sophia Tully, co-president of the Minority Association of Pre-Med Students at Northwestern, said she and her peers have struggled to reconcile with a system that often feels stacked against them. The 21-year-old plans on taking an extra gap year before medical school in an effort to save money. Tully summed up the environment on campus: 'For lack of a better word, people are panicking.'
The Herald Scotland
20-07-2025
- Health
- The Herald Scotland
Caregiving parents fear for disabled kids' lives under Medicaid cuts
The formula is covered through Medicaid, a program jointly funded by the federal government and states, which faces severe cuts through President Donald Trump's Republican-backed and recently passed reconciliation package. The law directly impacts nondisabled adults who must get a job or qualify for an exemption in order to maintain Medicaid coverage. But advocates are worried about how vulnerable populations might be harmed as states manage funding shortfalls due to other provisions in the law. Emma Staggs has bilateral vocal cord paralysis that prohibits her from swallowing or sounding out words, chronic lung disease, developmental delays and other daily health struggles. She survived the first months of her life in the intensive care unit after she was born at 1 pound, 9 ounces. In addition to the formula she needs to survive, Medicaid covers a pulse oximeter, oxygen concentrator, oxygen tanks for travel and a heap of other medical equipment in her North Carolina bedroom. The program also pays for in-home health nurses who help her eat and breathe and occupational therapy at a farm that helps her gain strength and dexterity to be able to use her hands. It covered horseback-riding physical therapy that helped her climb stairs this year. The Staggs are on edge. For them, it's no question that the new law could put their ability to cover the cost of their daughter's care in jeopardy. The law slashes the amount of federal money given to states to fund their Medicaid programs, so now states will have to decide which programs to cut. The North Carolina program that funds Emma Staggs's formula, medical equipment, health nurses and occupational therapy is called the Katie Beckett waiver or the Community Alternatives Program for Children. It's a Medicaid waiver that helps families of children who have complex needs and long-term disabilities receive and sustain at-home care so their children do not need to be cared for in an institution. Stacy Staggs is worried that it could end up on the chopping block. "We would have to take out loans, sell the house and move in with my mom," Staggs said. "We would go into medical bankruptcy to keep Emma alive." Officials from North Carolina's Department of Health and Human Services have not said whether the waiver will be cut due to reduced Medicaid revenue. James Werner, a spokesperson for the department, said in an email to USA TODAY officials are "reviewing the final legislation to determine its full impact on the state and its residents." "These cuts not only impact the people that rely on them directly but also strain the systems and communities that hold us all together," Werner said. Millions of children and adults with disabilities enrolled in Medicaid rely on the medications, equipment and staff the program covers to stay healthy, survive and be active members in their communities. Without in-home help, and sometimes even with it, family caregivers - frequently mothers - often pick up the slack, switching jobs or leaving their careers behind to care for their kids with special needs. The cuts to Medicaid could exacerbate that reality. For the Staggs family, it's a matter of life and death. "If we get to a place where we're no longer eligible, I can start a timer on how much longer Emma will be alive," Stacy Staggs said. "That's the end of it. It's not abstract. It's not hyperbole. It's the only thing that she can eat. There isn't any substitute." What is Medicaid, who uses it and what's changed? Some states have opted to expand Medicaid to help families pay for items their children with disabilities need that other health insurance companies might not cover, like wheelchairs, car seats and communication devices. There's no other program that comes close to the support Medicaid provides for recipients and their families, said Sara Rosenbaum, a professor of health law and policy at George Washington University's Milken Institute School of Public Health. "There's no health system recovery from a destroyed Medicaid program," Rosenbaum said. How Trump's tax bill Could cut Medicaid for millions of Americans Nearly half of the 78 million people who were enrolled in Medicaid and Children's Health Insurance Programs at the start of the year were children, according to the federal government. One in 5 children in the United States has special health care needs, and about half of those kids have coverage through Medicaid or the Children's Health Insurance Program, according to Georgetown University's McCourt School of Public Policy Center for Children and Families. The Trump administration's Medicaid cuts will leave nearly 12 million people uninsured by 2034, according to a cost estimate from the Congressional Budget Office. Another estimate from the Senate Joint Economic Committee Minority says it's closer to 20 million people. The new law increases Medicaid eligibility checks from once a year to twice a year, leading to more paperwork and potentially delayed funding for already overwhelmed families like the Staggs. This goes into effect on Jan. 1, 2027. States with robust Medicaid expansion programs, also known as "optional" enrollments, will also have to roll back supports because they'll receive less money from the federal government to fund them. Medicaid's opponents "just don't understand the program," said Kim Musheno, senior director of Medicaid for the disability advocacy group The Arc. "They just see a price tag," Rosenbaum said. "And the price tag is for people they consider wholly undesirable." 'Attack on rural America' Kentucky governor hits Medicaid cuts in Trump's megabill Supporters of the GOP's plan, including Speaker Mike Johnson, said the federal government needs to slash funding and that Medicaid needs to be more efficient. He also said able-bodied people who don't work and undocumented immigrants should be barred from receiving medical assistance in an interview with CBS News in May. Those who don't work are "taking advantage of the system," he said. "What we're doing is working on fraud, waste and abuse," Johnson said. In-home help is essential for caregiver parents Lindsay Latham, a mother in Virginia, doesn't want to quit the job she loves as director of operations for a lighting company. But she'll likely have to if Medicaid cuts strip her 11-year-old son of in-home care. Her son, Calvin Latham, was born with a brain malformation. Doctors told them he might never walk or talk, and that he'd likely develop epilepsy. He's progressed a lot since then, Latham said, but he still needs help eating, drinking, bathing and getting dressed. Latham said she thought their family's health insurance would cover her son's medical needs. But it didn't cover all of it. Medicaid has picked up the rest of the tab to cover things her and her husband's insurance won't, including his car seat, an adaptive stroller, a speech device, anticonvulsant medications and in-home attendant care to help him get out of bed and ready for school in the mornings, and bathed and back in bed at night. It wasn't easy, Latham said. Her son's Medicaid application was rejected three times before he was enrolled through the Commonwealth Coordinated Care Plus Waiver. She's bracing for more red tape with the new requirements that involve more frequent eligibility checks. "To make it harder for people who are working to fill out paperwork to maintain their medical coverage," Latham said. "It's cruel." More pressing, Latham is worried the state will reduce or cut her son's attendant and respite care if the reduced federal match can't support the hours he needs. The state's Medicaid budget is already strapped, she said, and her son receives minimal hours through his Medicaid wavier. Her son is on a waitlist for the state's Developmental Disability Community Living Waiver, also funded through Medicaid, which provides in-home care. It's a long list, she said, and she's been told he might not get off it until he's 30. She's terrified the state will cut or shrink the program even more. "This isn't just an immediate effect on Calvin's life," she said. "This is going to be lifelong." Virginia Gov. Glenn Youngkin's office did not respond to USA TODAY's inquiry about what programs will be eliminated or reduced due to the federal Medicaid cuts. If Medicaid no longer covers her son's attendant care, especially during the summer months when he's out of school, Latham said all of his caregiving duties will fall to her and she'd become a stay-at-home mom. As the breadwinner of the family, she said, that would mean the Lathams won't be able to afford updating their home as their son grows up and starts to need a wheelchair and wheelchair-accessible entryways. "We're not on this because we're trying to play the system," Latham said. "We're on it because we need it. He needs it. He deserves to have a fulfilling, rich life in his community." 'Really a lot at stake' Doctors told Mary Caruso the chances of her having a child with Friedreich's ataxia, a rare genetic disorder that affects the nervous system, were 25%. She didn't have one child with the disease. She had two. "We do play lotto," Caruso joked. Thirty years later, Caruso said her family has finally settled into a routine that includes a rotation of more than a dozen health attendants covered through Connecticut's Community First Choice program, a Medicaid expansion program through the Affordable Care Act. Both of her children - 35-year-old Alexandria Bode and 38-year-old Sam Bode - have jobs and spend time volunteering and participating in various community events with the help of their staff. "We have some amazing people here," Caruso said. "I don't know, honestly, what we would do without them." Connecticut Gov. Ned Lamont's office did not respond to USA TODAY's inquiry on whether the state will cut or reduce services for those enrolled in the Community First Choice program. If the state opts to reduce expansion programs because of federal Medicaid cuts, and the Bode siblings lose coverage, Caruso said they'll have to leave their jobs. It would fall to Caruso to help them eat, drink, bathe, dress and perform most other daily activities. "It's hard to really understand how valuable caregivers and these programs are. And you're talking about two people who want to be part of society," Caruso said. "They have a right to be, and they can't do it alone, physically." There is "really a lot at stake," Caruso said. She won't consider ever putting her children in a facility. She'd care for them herself until she died. "But it would not be easy," she said. After working to live on her own, 'Could this mean that I have to move back?' Other family caregivers who recently found respite might find themselves back in a caregiving role if their adult children are kicked off Medicaid. James Rothchild said his daughter was diagnosed with autism when she was 3 years old. It was a "lengthy process" for her to get ready to live on her own, he said, and he wasn't always convinced it would be possible. But Chloe Rothschild, 32, moved out 2 1/2 years ago. To prepare for the move, Chloe Rothschild said she spent more than 10 years practicing various skills like working with her in-home aide staff, staying alone overnight and cooking and cleaning. "I worked really hard to get here," she said. "So, I don't want to go backward." Rothschild said her direct support providers, who are paid through a Medicaid waiver, come by for one to three hours, four to five days a week, to help her cook, clean, shop and organize. "I'm really thriving," she said. "And I'm continuing to make progress and gain skills. Like just this weekend, I'm going out of town for work. And for the first time ever, no one is going with me." Dan Tierney, deputy director of media relations from Ohio Gov. Mike DeWine's office, said the state is "still reviewing the bill for potential impacts." "But we do not anticipate any major cuts in Ohio as a result of the bill's passage," Tierney wrote in an email to USA TODAY. Rothschild isn't convinced. If Medicaid cuts reduce her hours of support or cut them entirely, she's worried it would lead to skill regression and potentially take away her independence. She wonders: "Could this mean that I have to move back in with my family?" She can't live on her own without in-home help, her father said. "It would be fairly devastating," he said. "It would not be good for our family." 'More pressure on families' Nearly half of US states are on the brink of a caregiving emergency 'It's going to be those of us with disabilities' Emma Staggs will never be able to live independently. Medicaid has funded nearly $4 million of her life-saving care for nearly 12 years, her mother said. That's only for a portion of the services she needs to survive. Her father's private medical insurance pays for the rest. Staggs said she is furious about what the potential loss of Medicaid could mean for her family and others like them. Their fate is in the hands of the state now. "The goal of all of this is less people going forward, and it's going to be those with disabilities and an inability to work in the workforce," she said. She and her family lobbied in Washington, D.C., in the days before the bill passed. They now plan to target their state lawmakers. In the meantime, Staggs has attempted to ration the formula she gets by diluting it with water. Sometimes she gives her daughter Gatorade instead. And she's made an appointment with her daughter's doctor to see if they can try another feeding option or a backlog supply of the formula while they are guaranteed Medicaid. "That's the part that has me in real panic," Staggs said. "When they're talking about an end date to Medicaid, it's like saying how long they're keeping Emma alive." Madeline Mitchell's role covering women and the caregiving economy at USA TODAY is supported by a partnership with Pivotal Ventures and Journalism Funding Partners. Funders do not provide editorial input. Reach Madeline at memitchell@ and @maddiemitch_ on X. Contact Kayla Jimenez at kjimenez@ Follow her on X at @kaylajjimenez.
