What can we learn from the midterms?
For one, working-class Americans across the country want access to healthcare and strongly support Medicaid. They want a healthcare system that heals, not harms. They want a system that won’t break the bank, bury people in medical debt, or push families into lifelong financial ruin. Voters also seem to be embracing expert healthcare workers and rejecting right-wing misinformation like never before.
For example, Senator-elect Dr. Abdul El Sayed won people over, in part, by being forthcoming about his medical background on the campaign trail, declaring: “It shouldn’t be this hard to see a doctor in the richest and most powerful country in the world.” Meanwhile, the revelation that Roger Marshall sued hundreds of patients for medical debt — some of whom were even arrested — seemed to be the nail in the coffin of his race. He lost to Senator-elect Adam Hamilton in Kansas.
Today’s live conversation touches on the midterms and more, from a healthcare worker herself — Emily Birnbaum. Emily is a Medical Debt organizer and nurse practitioner, board-certified in both Psychiatry and Family Medicine. She was born and raised in the Bay Area and has helped hundreds of patients. Emily most recently graduated from Vanderbilt School of Nursing and spearheads the Healthcare Worker Solidarity Collective — a group of healthcare workers who meet regularly and discuss how to fight back against our for-profit-driven healthcare system. Care is the cornerstone of her leftist politics and practice.
But first, here’s why this convo is so important: while there’s much to celebrate post midterms, we can’t lose sight of what’s up ahead. OBBBA (One Big Beautiful Bill Act or HR-1) has already set life-threatening cuts to healthcare in motion. A shocking 18 million Americans will lose healthcare coverage in January. But the mayhem won’t happen overnight. Instead, HR-1 slowly erodes the best parts of Medicaid and puts people’s lives at risk to line the pockets of the ultra-rich. The Trump administration knows that healthcare is infrastructure, so they’re dismantling it piece by piece in an effort to privatize the entire system for good.
Means Testing
The process of using bureaucracy and financial evaluation to gate keep government assistance has a name. It’s called Means Testing, and unfortunately it’s a tactic imposed by both Republicans and Democrats. Instead of ensuring everyone has access to services like free school meals, education or healthcare, the government instead requires individuals to navigate complex and unnecessary bureaucratic hurdles to get help, all while rules change from administration to administration. Research shows that Means Testing — instead of keeping so-called “unqualified” people from receiving help — actually prevents those most in need from accessing services. It’s also extremely costly. And in healthcare, the stakes of rolling out these measures is often a matter of life and death. For example, HR-1 is a Means Testing monster because it’ll forces work requirements on disabled people and it guts spending on rural hospitals. What do these cruel cuts pay for? $150 billion in new defense spending for a department that fails its audit every year. Plus, $170 billion for ICE. Though these changes will be daunting, we can prepare ourselves by organizing and building solidarity right now.
Pack the M.A.C!
Americans across the country can learn from what’s happening in Nebraska. In December 2025, Governor Jim Pillen and leaders in the state’s Department of Health and Human Services put Nebraska first in line to implement the HR-1 cuts to Medicaid. But Nebraskans didn’t ask to be guinea pigs for this botched federal healthcare mandate and haven’t been given a say since.
Debt Collective’s Medical Debt team will be in Lincoln, Nebraska alongside local DSA organizers for an in-person action: Pack the M.A.C. (Medicaid Advisory Committee). Please join us if you live in Nebraska. If you can’t make it in person — call DHHS (Department of Health and Human Services) and demand they pause HR-1 cuts effective immediately. Even if you don’t live in Nebraska, you can help us bring national attention to impending attacks on healthcare infrastructure by joining upcoming Debt Collective calls. Be sure to talk to your friends and family about healthcare over the holidays as well.
Remember, an attack on healthcare infrastructure, is an attack on us all.
