Lt. Gov. Kyle Evans Gay is the chair of the Delaware Behavioral Health Consortium. Carolyn Petrak is a voting member of the consortium and the executive director of the Ability Network of Delaware.
In July, Congress passed House Resolution 1, commonly referred to as the “Big Beautiful Bill.” The bill will be debilitating for our already struggling care economy. Implementation of the bill was strategically delayed but make no mistake: Funding cuts are coming. With a projected $900 billion reduction in Medicaid funding over the next decade, no state will be immune from the unimaginable consequences of those cuts.
These cuts will hollow out hospitals and leave patients without access to routine, preventive, specialty and emergency care. But we cannot forget that Medicaid doesn’t just serve Delawareans in traditional medical settings; Medicaid funds state-contracted, community-based services for Delawareans with disabilities, mental illness and substance use disorders — an intricate system of care that is delivered in every corner of our state.
For the roughly 20% of Delawareans enrolled in Medicaid, the loss of health care insurance coverage will have lasting effects on their ability to stay healthy over time. But the story — the harm and the heartache — is much greater and more insidious.
Community-based services supported by Medicaid allow Delawareans with disabilities and behavioral health needs to live with dignity, contribute to our economy and remain connected to their communities. These programs aren’t just “nice to have.” When these programs are threatened, the burden often shifts squarely to families. Parents, siblings and spouses are left to provide 24/7 care, often forced to choose between their loved one’s needs and their own livelihoods. In Delaware, Medicaid funding is essential to our local economy because it keeps family members in the workforce. It keeps vulnerable Delawareans safe. It supports a crucial but often underrecognized sector in the health care workforce.
And so, the consequences of the coming cuts will ripple far and wide. Without adequate funding, people with disabilities and mental health conditions risk being cut off from opportunities to work, learn and belong. And the workforce that supports them — dedicated professionals in disability services, mental health care, addiction recovery and vocational training — face layoffs, loss of income and potential reliance on public assistance themselves.
Make no mistake: Medicaid touches every community in Delaware. It funds the services that allow our neighbors to thrive, our families to stay together and a workforce to remain strong. By politicizing Medicaid, proponents of the “Big Beautiful Bill” are weakening our economy and dismantling systems of care. The “Big Beautiful Bill” does not reflect or honor our shared humanity. It is not who we are, and it’s certainly not who we can afford to be.
Reader reactions, pro or con, are welcomed at civiltalk@iniusa.org.
