Gutting Medicaid is a Public Safety Crisis in the Making

On July 4th, while much of the country was celebrating our independence, President Trump signed a tax and policy bill that included deep cuts to the social safety net. The legislation, dubbed the “One Big Beautiful Bill Act,” will reduce Medicaid funding by $1 trillion over the next ten years. By Congress’s own estimate, nearly 12 million people could lose their health insurance by 2034. 

As a former Chief of Police and a former mental health professional, we come from different corners of public service—but we’ve seen the same truth play out time and again: when people don’t have access to the care they need, you create the conditions for crisis. We’ve seen how quickly untreated trauma, addiction, or illness can escalate: communities become destabilized, individuals are left without support, and public safety erodes. And we’ve seen how the burden of that crisis lands on first responders who are ill-equipped to provide appropriate care.

Cutting Medicaid will make our communities both sicker and less safe.

The Link Between Health and Safety

Medicaid is one of the largest anti-poverty programs in the country and a lifeline for millions—particularly for low-income people with disabilities, behavioral health needs, substance use disorders, and those reentering society after incarceration. For those of us who have spent our careers in public safety and mental health, we know the connection between these services and public safety is unmistakable. 

When people don’t have access to healthcare, particularly mental health and substance use treatment, their challenges often become criminalized. Police officers are then called to respond to crises they are not trained or equipped to handle. Help arrives not in the form of a treatment plan, but in the form of a badge, gun, and handcuffs. That’s not public safety. That’s a system failure. 

Evidence-Based Solutions

Research confirms what many of us on the frontlines have witnessed on the ground. Medicaid coverage improves access to substance use treatment, mental health services, and is also associated with reduced crime rates. Research shows that states that expanded Medicaid under the Affordable Care Act experienced significant annual decreases in crime, specifically violent and property crimes. This resulted in an estimated $13 billion in cost savings.

Medicaid also plays a key role in funding alternative response programs—teams that send behavioral health professionals or trained community responders to calls for service involving mental health or substance use crises. These programs reduce unnecessary police contact, prevent unnecessary arrests, and connect people to the help they actually need. In many communities, these programs would not exist without Medicaid reimbursement. 

The Cost of Cutting Care

We’ve already seen what happens when access to care disappears. In 2005,  Tennessee removed more than 190,000 people from its Medicaid roles. The result? Counties saw a 7.1% increase in reported crime, driven largely by nonviolent offenses like theft. People turned to desperate measures to meet basic needs or cope with untreated health issues. Extrapolate that to 12 million people nationwide, and the consequences are chilling.

The brunt of these Medicaid cuts will fall hardest on communities of color. Nearly 60% of Medicaid recipients are people of color, and almost half of all children of color are served by the program. Slashing Medicaid doesn’t just withdraw healthcare—it pulls vital infrastructure out from already vulnerable communities.

Public Safety and Public Health are on the Line

Both of us have worked in systems that are understaffed, overburdened, and stretched too thin. Removing Medicaid support from our communities will only increase pressure on those still on the front lines, often at greater cost and with worse outcomes. 

Studies show that Medicaid has a significant return on investment by improving economic stability, improving health outcomes, and reducing reliance on costly emergency medical care. Further, evidence suggests that providing access to treatment is more cost-effective than incarceration because treatment programs help reduce recidivism rates. 

The Path Forward

A public safety system must be built on care, trust, equity, and accountability. Medicaid delivers that care everyday across the country. It funds the very programs that reduce arrests, stabilize families, and connect people with the treatment they need to live healthier lives.

Stripping this lifeline away will unravel the progress we’ve made toward more humane, cost-effective, and community-centered approaches to safety. As someone who wore the badge — and another who worked in mental health — we can tell you: police officers are not the answer to every problem. 

If our leaders are serious about safety, they must fund the systems that keep people healthy, housed, and connected to care. Cutting Medicaid undercuts all of that. It leaves communities to navigate trauma without tools, and it leaves public servants to respond without support.

We urge lawmakers to protect Medicaid—and with it, the safety, health, and dignity of our communities.

Chris Burbank is the former Chief of Police of Salt Lake City. Candace Williams is a former mental health professional and current Community Engagement Manager at the Center for Policing Equity.