Making My Case for Care

March 2, 2025

Please know I am including this information as a healthcare provider concerned about access to care in rural Nebraska and beyond and not as a political statement. The U.S. Congress is in the process of budget reconciliation. Please inform yourself and make your voice heard. 

If you agree with the sentiment of this letter, you are welcome to use it as a template to write your congressional representative. 

Dear Congressman Smith,

I’m writing to you not just as a constituent but as a healthcare provider who sees firsthand how the decisions made in Washington affect real people here in Nebraska. I’m deeply worried about the proposed budget resolution for 2025 and what it could mean for our state, especially when it comes to healthcare, education, jobs, and the economy.

These cuts aren’t just numbers on a spreadsheet. They will have serious consequences for everyday Nebraskans. Let me share a few examples of what this could look like.

Mary is 73 and spent her life working on a family farm. After suffering a stroke, she relies on Medicare to cover her therapy and medications. If these cuts go through, she might not be able to afford the care she needs, putting her at risk for another stroke—one that could take away her independence or worse, her life.

James is a 32-year-old dad who works construction. His job doesn’t offer health insurance, and Medicaid helps him afford clinic visits for his kids and insulin for his diabetes. If Medicaid funding is slashed, he may not be able to afford his medication, putting him at risk for serious complications or even an emergency that could cost him his job.

Emily is a college student at UNMC who was diagnosed with multiple sclerosis when she was 19. She’s part of an NIH-funded clinical trial for a new treatment that could slow her disease and keep her mobile longer. If NIH research funding is cut, these studies could be delayed or canceled, leaving Emily and thousands of others with fewer options and no hope for future breakthroughs.

Cuts to these programs will hit Nebraska hard. More than 465,000 Nebraskans are on Medicaid, and over 380,000 rely on Medicare. Slashing funding means hospitals, especially in rural areas, will struggle to keep their doors open, and fewer people will have access to care. On top of that, research funding that supports medical breakthroughs and jobs in Nebraska will be at risk.

But it’s not just healthcare that will suffer. The budget proposal calls for big cuts to education funding, which means less money for Nebraska schools, universities, and job training programs. That could lead to higher tuition, fewer resources for students, and a workforce that’s less prepared for the future. Transportation funding is also on the chopping block, which could delay highway repairs and road projects that support agriculture, businesses, and trade.

If the federal government pulls back on these essential services, Nebraska will be forced to either raise state taxes or make its own cuts to healthcare, education, and infrastructure. That means hardworking families could see higher costs or fewer services, neither of which Nebraska can afford.

And then there’s agriculture. Nebraska depends on trade, but cuts to international aid programs like USAID could hurt the demand for our crops and livestock. We exported over $7 billion in agricultural products last year. If we don’t have strong global markets, Nebraska’s farmers and ranchers will feel the pain.

At the same time, this budget plan includes extending tax cuts similar to those passed in 2017. According to the Penn Wharton Budget Model, making these tax cuts permanent would add $6 trillion to the national debt over the next 10 years. Even if they expire in 2033, the plan would still increase the debt by $5 trillion.

The tax cuts would provide some short-term economic growth, but only for a while. The economy might grow slightly over the next decade, but if the tax cuts don’t expire, it could actually shrink after 2033, meaning wages and business investments could go down instead of up. And while these tax cuts are being sold as relief for all Americans, 56% of the benefits would go to the richest 10% of people, while the bottom 80%—which includes most working families—would only get 29% of the benefits.

I understand the need to be fiscally responsible, but we can’t do it at the expense of the people who need these programs the most. These cuts will make it harder for Nebraskans to get medical care, afford an education, find a job, and keep our economy strong.

I hope you’ll stand up for Nebraska and fight against these harmful cuts. I’d love to hear your thoughts on how we can protect our state’s future while making responsible budget decisions. Thanks for your time, and I appreciate all you do for Nebraska.

Sincerely,

Denise Waterfield, PhD, APRN-NP