Ellen Allen: Medicare also a target of Congress(Opinion)

Originally published on October 21st, 2025 in the Charleston Gazette-Mail.

For generations, West Virginians have worked hard, paid their dues and counted on Medicare to be there when they needed it. It’s not a handout, it’s a promise earned through a lifetime of work. But that promise is now under serious threat.

Buried deep inside the so-called “Big Beautiful Bill” is a dangerous budget gimmick that could slash Medicare by hundreds of billions of dollars over the next decade – hitting West Virginia’s seniors, hospitals and communities hardest.

The danger doesn’t come from a direct vote to cut Medicare — it’s more insidious. Under a rule called “Pay-As-You-Go” (PAYGO), any new law that increases the federal deficit automatically triggers cuts to programs like Medicare unless Congress votes to override them.

The “Big Beautiful Bill” is packed with expensive tax breaks for the wealthy and big corporations, blowing a massive hole in the deficit — and under PAYGO, that hole must be “paid for” through automatic cuts. Medicare is first in line.

These cuts could strip nearly $490 billion from Medicare over the next decade, including a 4%
annual cut to hospitals, doctors and nursing homes starting next year. That might sound small
on paper, but for rural states like ours, the damage could be devastating.

In West Virginia, the consequences won’t be abstract — they’ll be felt in every community. Nearly 470,000 West Virginians rely on Medicare, more than one-quarter of our population and one of the highest rates in the nation. Rural hospitals depend on Medicare reimbursements to keep their doors open, and many already operate on razor-thin margins; a 4% cut could be the difference between survival and closure.

Seniors would also face new barriers to care, as fewer providers could afford to see Medicare patients, forcing older West Virginians to travel farther, endure longer wait times, and shoulder higher out-of-pocket costs. And when a hospital closes, everyone suffers — jobs disappear, emergency response times lengthen, and entire local economies begin to unravel.

Full disclosure: In less than a year, I’ll be feeling the potential Medicare cuts myself — this after several months of enduring the outrageous, unconscionable 400% increase expected for my ACA premium that kicks in at the end of this year.

Supporters of the “Big Beautiful Bill” claim that Medicare won’t be touched. But that’s simply not true — and West Virginians deserve the truth. Our entire congressional delegation voted for and continues to support this bill, even though they know full well it triggers automatic PAYGO cuts unless Congress acts to stop them.

They can’t have it both ways: you can’t vote for a bill that sets Medicare cuts in motion and then tell seniors their benefits are safe. That’s not protecting Medicare — that’s misleading the very people who rely on it most, and it betrays the promise leaders of both parties have made to West Virginians for decades: that Medicare would remain strong, reliable, and protected from politics.

These cuts are not inevitable. Congress can vote to exempt Medicare from PAYGO sequestration at any time. They can pay for new policies honestly, rather than letting a budget rule quietly do what no one would dare vote for in daylight.

West Virginians have a right to expect better. We can call on our senators and representatives to protect Medicare from PAYGO cuts and ensure that automatic budget rules never gut the program we’ve all paid into. Lawmakers should reject tax giveaways that put seniors at risk. If they want new spending or tax breaks, they should pay for them responsibly. And above all, our leaders must tell the truth: stop pretending Medicare is safe while voting for bills that cut it.

Medicare isn’t charity, it’s a covenant. It’s the assurance that if you work hard and play by the rules, you’ll have health security and dignity in your later years. In a state where families have given everything — in the mines, in classrooms, in the military — that promise matters. It’s the difference between stability and despair.

So, when Congress threatens to break that promise through clever accounting or cynical politics, West Virginians must speak with one voice: Hands off our Medicare.