U.S. Rep. Gabe Amo speaks at a press event at Women & Infants Hospital in Providence, on March, 10, 2025. Seated at left are U.S. Rep. Seth Magaziner and Dr. Jill L. Maron, the hospital’s pediatrician-in-chief. (Photo by Alexander Castro/Rhode Island Current)
Most of Rhode Island’s babies enter the world at Women & Infants Hospital.
Every year, the Providence hospital delivers about 85% of the children born in the Ocean State — a vast sample that contains pretty much every demographic group, including future elected officials.
“It’s great to be back to the place that I was born. I mean that specifically and very literally,” Democratic U.S. Rep. Gabe Amo told a crowd gathered in a conference room Monday at the hospital.
The congressman was joined by fellow Democrats, U.S. Sen. Sheldon Whitehouse and Rep. Seth Magaziner, to protest potential cuts to Medicaid, the public health insurance program that covers about 44% of births in Rhode Island. The three are especially concerned about a budget resolution passed last month by Congressional Republicans seeking to eliminate $880 billion of the money controlled by the U.S. House Committee on Energy and Commerce — one of the oldest congressional bodies, and the one responsible for prescribing Medicaid’s funding — over the next 10 years to help pay for tax cuts.
“I am not a ‘hair on fire’ kind of person, but this is catastrophic,” Amo said.
Medicaid is projected to account for 93% of the Energy and Commerce budget through 2034, a total of $8.2 trillion, according to the Congressional Budget Office, which is tasked with performing nonpartisan analysis of congressional spending. To slash away $880 billion over the next decade would be impossible without removing parts of Medicaid and the Children’s Health Insurance Program, as the remainder of the committee’s budget does not equal that much.
“How do we know they’re doing this? Well, you just do the math,” Whitehouse said. “They put so much money into the accounts that fund Medicaid that they want to take back, but there’s no way you can do what they said without the huge cuts to Medicaid that we see coming…There’s no deduction that is possible other than they’re coming after Medicaid, and it’s going to hurt all of these folks.”
Stephanie Manfredo is one of the Rhode Islanders who relies on Medicaid and was present shared her story. Her oldest son is 12 and was born with a rare genetic condition involving epilepsy and intellectual disability. “His level of care requires many medical and community support services that can only be accessed through Medicaid,” Manfredo said.
Manfredo’s 10-year-old son also uses Medicaid to access behavioral health services. And last October, she gave birth to her youngest son at Women & Infants, a pregnancy that was complicated and “needed a fair amount of medical intervention” for both Manfredo and her newborn, she said.
“I’m incredibly grateful to my providers for being so proactive to make sure my baby only stayed healthy throughout my pregnancy and to his birth,” Manfredo said. “But I can’t imagine the expenses my family would have incurred had I not had Medicaid coverage.”
Hosting Manfredo and the delegation Monday was Dr. Michael Wagner, CEO of the hospital’s parent company, Care New England. Wagner, who has previously expressed public concern about Medicaid cuts, highlighted how his hospitals depend “deeply” on Medicaid. He added that the proposed cuts are “an assault on health care delivery for the most vulnerable populations in our state.”
A third of the state’s population
States administer Medicaid differently, with services and coverage varying from state to state. The Affordable Care Act in 2010 allowed states to expand eligibility for their Medicaid programs. Today, most adults who make up to 138% of the Federal Poverty Level — an individual earning under $21,600 annually — are eligible for Medicaid coverage in the 40 states plus Washington, D.C. that expanded coverage. Only 10 states have not adopted Medicaid expansion.
Magaziner recounted a conversation with a Republican colleague on the Energy and Commerce Committee, who said the Medicaid cuts could be accomplished by dismantling Medicaid expansion.
“That’s the part that they’re going to look to roll back,” Magaziner said. “This is what he told me, because it only impacts what he called the blue states. But he’s actually wrong about that, because North Carolina’s a Medicaid expansion state. Ohio, Arkansas, Louisiana, et cetera.”
Attempts to repeal portions of the Affordable Care Act have been tricky to accomplish. Similar GOP-led maneuvers to eviscerate Medicaid funding narrowly failed in 2017, with a few congressional Republicans concerned the cuts might affect the health care industry’s bottom line.
But in a post-COVID landscape, Medicaid’s growth in spending — $300 billion over the last eight years, mostly thanks to increased eligibility during the pandemic — has become a lucrative target for Republicans who want to liberate trillions to maintain President Donald Trump’s 2017 tax cuts.
“Why are our Republican colleagues doing this? They are doing it to find the money to pay for tax cuts, mostly for people who are very rich, who don’t need them,” Magaziner argued.
Medicaid comprises a significant part of Rhode Island’s state expenditures as well. Kristin Sousa, the director of Rhode Island’s Medicaid program, was at the Rhode Island State House on Feb. 25 to give state senators a routine update on Rhode Island’s Medicaid programming.
“From an enrollment perspective, we cover nearly a third of Rhode Islanders in every city and town,” Sousa testified at the committee meeting.
Children and families make up the majority of the state’s Medicaid population, Sousa said, followed by adults covered under the expansion. These adults are between the ages of 19 and 64, do not have dependent children, are not pregnant, are not eligible for Medicare and they have no other insurance.
Children with special health needs, or those receiving services via the state’s child welfare agency, comprise a smaller portion of the state’s Medicaid rolls. Most of the state’s Medicaid enrollees, 88%, are enrolled in managed care, so they receive coverage through insurers like Neighborhood Health Plan of Rhode Island.
Sousa also affirmed that Medicaid reimbursements “tend to have very low rates nationally,” she said. “It’s not a secret that the rates are not usually what providers would say are adequate.”
Sousa told senators then that it was too early to speculate on how potential cuts might affect the state’s Medicaid program.
“I think it’s hard to talk about that right now because we don’t know what will happen,” Sousa said. “But the focus for myself and my team will be to take what comes and evaluate that, to try to minimize the impact to the beneficiaries, and obviously to be as fiscally responsible as we can.”
At Monday’s press conference, Magaziner was more willing to predict the future. He offered that the state may have to “drop thousands” of people from the Medicaid rolls, reduce the scope of services covered, or “cut the state budget in a draconian way in order to make up the difference.”
“You could cut everything under Energy and Commerce, every single thing down to zero, except for Medicare and Medicaid, and you’ll have only cut $200 billion,” Magaziner said. “That means that states like Rhode Island are going to have to make a terrible decision.”
One fourth of the state’s congressional delegation was missing from Monday’s event. Sen. Jack Reed, was “out of town,” Whitehouse said, but sent his regards. A spokesperson for Sen. Reed said he was in Washington, D.C., on Monday.
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