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When Dr. Marketta Blue bursts into an examination room, she greets her patients as long-lost friends, a whirl of energy in leopard-print Crocs: “Tell me what’s up!”
Dr. Blue is a family physician at Delta Health Center, the oldest federally funded rural community health center in the United States. The center sits in the Mississippi Delta, at the entrance to Mound Bayou, which was founded in 1887 as an all-Black town. Today, more than half of the town’s children live below the federal poverty line. Last year, the health center saw just over 14,000 patients, 36 percent of whom had Medicaid.
Dr. Blue, 38, grew up in the region and lived with her grandmother, who could not afford to take time off work for medical appointments. She saw a doctor only if she was “bleeding from the eyes, mouth and nose,” she recalled. That experience, she added, left her attuned to the many reasons that her own patients might struggle to come see her: Maybe they can’t afford the gas to drive there, can’t cover child care or have lost their health insurance.
Insurance was on the mind of one patient, Johnie Williams, 64, who shifted uncomfortably in his wheelchair as Dr. Blue entered his exam room in early September. His wife, Carolyn Williams, sat nearby, cradling their granddaughter. He was having trouble sleeping at night, he told Dr. Blue. When he lay down in bed, his lungs felt like cement, like no air could pass through. He felt nauseated all the time, which made it hard to eat.
Also, he said, “Medicaid cut me off.” He had received a letter about the change in his coverage in July, although he noted that he still had health care coverage through Medicare. (He’d previously had both.) “They said by me and my wife being in the same household, the same address, that our income was a few dollars over the limit,” he added.
Dr. Blue’s face twisted in alarm. “Oh my gosh,” she said.
Their conversation could well be a precursor to many similar ones to come. The health care provisions in the Trump administration’s tax and domestic policy bill, passed in July, mean that 10 million more Americans will become uninsured by 2034, according to estimates from the Congressional Budget Office. Federal spending on Medicaid will be reduced by more than $1 trillion, the largest reduction to Medicaid since the creation of the program in 1965.