As budget negotiations continue in Harrisburg, Pennsylvania lawmakers are faced with a defining decision: Will they protect the health and dignity of millions, or allow devastating federal cuts to Medicaid and the Children’s Health Insurance Program (CHIP) to take hold?
This choice isn’t just about numbers on a spreadsheet — it’s about the lives of more than 3.7 million Pennsylvanians who rely on these programs every day. And for many, especially those living in communities long burdened by industrial pollution and environmental injustice, the stakes are even higher.
The impact of these proposed cuts would extend far beyond Medicaid and CHIP. They threaten the very foundation of public health in our commonwealth. Programs administered by the Pennsylvania Department of Health (DOH) — from lead poisoning prevention and cancer screenings to rural health outreach and emergency preparedness — could be scaled back or eliminated altogether.
That’s a risk Pennsylvania can’t afford.
In cities and towns like Monessen, Clairton, Aliquippa, Norristown and neighborhoods across Philadelphia — places shaped by the rise and decline of industry — residents are already grappling with the consequences of toxic air, contaminated water and deteriorating housing. These are not abstract concerns. They translate into real health consequences: higher rates of asthma, cancer, birth defects, cardiovascular disease and cognitive impairments.
And the burden isn’t shared equally. Children, seniors, and Black and brown Pennsylvanians — many of whom rely on Medicaid — bear the brunt of this crisis. In communities like these, access to health care isn’t a luxury; it’s a lifeline. Medicaid and CHIP provide the only viable path to diagnosing, treating and managing chronic illness before it becomes fatal or financially ruinous.
Let’s be clear: Cutting these programs would deepen the very inequities our state should be working to address. It would send a message that the health of some Pennsylvanians matters less than others. That we can tolerate decades of pollution, disinvestment and harm — without ensuring care and accountability in return.
That is unacceptable.
Medicaid and CHIP do more than cover hospital visits — they support environmental health screenings, keep clinics open in vulnerable areas and help families rebuild from systemic harm. Preserving these programs is not just fiscally smart — it is morally necessary.
Now is the moment for lawmakers to lead with conscience and courage. They must reject these federal cuts, reinforce public health funding, and prioritize the people and communities most affected by environmental harm. The budget is not just a policy document — it’s a reflection of our values.
If we truly believe in equity, in health and in justice, we must act accordingly. Pennsylvania’s future depends on it.
Matt Shorraw is with Physicians for Social Responsibility of Pennsylvania.