By Leni Preston and Jeananne Sciabarra

Like many Marylanders, we are angry and dismayed that “leaders” in Washington, D.C., are intentionally undermining our health care system for political gain.

In the Trump administration’s proposed budget and the Republicans’ American Health Care Act (AHCA), we see a health care catastrophe in the making, with the most vulnerable people in the nation and in Maryland at highest risk of suffering the most.

As passed by the House of Representatives, the AHCA would effectively price many people out of the private insurance market completely by drastically cutting subsidies to help purchase coverage.

More devastating, however, are the proposed cuts to the Medicaid program. The AHCA would effectively end the Medicaid expansion launched under the Affordable Care Act and would implement per capita caps that, according to the Congressional Budget Office (CBO), would cut Medicaid spending by $834 billion over the next 10 years.

Far from providing states with “flexibility,” as Republicans assert, these draconian cuts would force states to cut enrollees, reduce benefits and lower provider payments. The CBO projects that the result would be 14 million fewer Americans insured under this vital safety net program. Current deliberations in the Senate, being carried out in secret with no hearings scheduled to date, do not appear to offer hope for a bill that will actually increase coverage and reduce costs, as Republicans and the president have promised.

In Maryland, all of that translates to 265,100 people losing health coverage by 2026, including 148,600 people who rely on Medicaid, according to the Center for American Progress. For the state to prevent such losses, it would have to make up billions of dollars in funding to continue the expansion and restore the deep cuts that per capita caps would create.

As if that wasn’t bad enough, the president’s proposed budget takes another sledgehammer to Medicaid by cutting an additional $610 billion over 10 years, which will reduce or eliminate coverage for many more Marylanders. They will be left without affordable insurance, putting their health and financial security at risk.

The administration’s budget adds further insult to injury by attacking additional safety net programs that help families cope with other pressing needs that have a direct impact on their health. For example, the budget slashes the Supplemental Nutrition Assistance Program (SNAP, or food stamps) by 36 percent, potentially eliminating nutrition assistance for 199,000 Marylanders, 66 percent of whom live in households with children. Dire cuts are also proposed for affordable housing, early childhood education and programs to ensure clean air and clean water.

Here in Maryland, Consumer Health First is doing its best to mitigate as much as possible the devastating impact of federal cuts on our fellow residents by convening a collaborative of stakeholders who work with and advocate for Medicaid recipients in Maryland. This work is made meaningful by the fact that, in the past legislative session, we successfully got language added to the Budget Reconciliation and Financing Act to ensure that the state must consult with key stakeholders about any change to Medicaid or the state Food Stamp program. This gives those with roots in the impacted communities a role in the state’s process in responding to federal cuts.

These efforts are important, but they won’t be enough to protect everyone. The federal government cannot make cuts of this magnitude without doing serious damage to people’s lives. In addition to potential cuts in enrollment, benefits or provider payments, we are equally concerned about attempts to establish cost-sharing and work requirements that would simply create new barriers to accessing the quality care that we believe is a basic human right.

Simply put, the federal government must stop playing politics with our health care. The consequences are just too serious. One in five Marylanders is covered through Medicaid so, quite literally, lives are hanging in the balance.

We applaud those in our congressional delegation who are pushing back on attempts to blow up the Affordable Care Act and we, with our partners, stand ready to work with the Hogan administration to protect the gains we’ve made and to preserve quality health care coverage for Maryland’s low-income, children, elderly, and disabled populations.

We must not only keep Medicaid as we know it, we must also work together to continually improve it. That is the only path to health justice.

Leni Preston is president of Consumer Health First. Jeananne Sciabarra is executive director.