While Donald Trump is once again touting his so-called “great, big, beautiful bill” — this time slashing Medicaid and essential support for low-income families while handing out tax cuts to the ultra-wealthy — one state leader is offering a radically different vision.
Dr. Josh Green, a physician and the governor of Hawaii, is making the rounds on talk shows and community forums with a message rooted in compassion, common sense, and economic savvy: expanding Medicaid is not just morally right — it’s good for business.
Hawaii’s Medicaid expansion is aimed at increasing access to healthcare for low-income residents — those most often left behind in the American healthcare system. But what Governor Green understands, and what every state leader should take seriously, is that this isn’t just about healthcare access. It’s about creating a stronger, more resilient Economy from the ground up.
Medicaid keeps hospitals open in underserved areas. It allows small clinics to operate where private insurance doesn’t reach. It supports thousands of medical jobs and ensures that patients can afford preventative care rather than waiting until they’re in crisis. In other words, it stabilizes local economies while improving public Health.
When people are healthy, they can work. When hospitals stay open, jobs stay local. And when more residents are covered, everyone is safer — because viruses, bacteria, and Chronic Conditions don’t check your insurance status before spreading.
Contrast this with Donald Trump’s ongoing assault on the safety net. His new legislative push seeks to slash Medicaid, gutting one of the most important public health programs in U.S. history. These cuts won’t just hurt “the poor.” They’ll hurt all of us. And his proposed tax cut is so large, it blows up the national debt even with planned cuts to Medicaid.
Every dollar taken out of Medicaid is a dollar taken away from community hospitals, nurses, home health workers, pharmacists, and preventive programs. It’s a direct blow to public health infrastructure — especially devastating in the wake of a global pandemic that taught us how deeply interconnected we are.
If the working poor and vulnerable populations can’t afford medicine, vaccines, or a check-up, it’s not just their problem. It’s everyone’s. Outbreaks spread. Emergency rooms overflow. Untreated conditions worsen until they require far more expensive interventions — interventions that will ultimately require taxpayers to foot the bill.
Medicaid isn’t a handout. It’s a ladder. And cutting it off to fund tax breaks for billionaires isn’t just morally indefensible — it’s economically reckless.
Governor Green gets it. He’s showing the country what forward-thinking, bipartisan healthcare policy looks like — rooted in evidence, economics, and empathy. Trump, meanwhile, continues to punch down, targeting those with the least power and the fewest resources in our society. And he’s not alone.
As of May 9,2025, 40 American states and the District of Columbia have either adapted Medicaid expansion or are moving with action directed at Medicaid Expansion. Only Alabama, Wisconsin, Wyoming, Mississippi, Tennessee, Georgia, Florida, Texas, Missouri, and South Carolina have not adopted the expansion.
In the end, this isn’t some minor policy debate—it’s a reflection of who we are and what we value. Do we believe in a society where everyone, regardless of income, has access to the care they need to survive and thrive? Or do we believe in trickle-down fantasies where millions suffer needlessly while the mega-rich get richer?
The choice is clear. Medicaid expansion is the smart, moral, and economically sound path forward. And any effort to dismantle it — no matter how “beautifully” packaged — is a betrayal of the American people.
Mark M. Bello is an attorney and author of 9 Zachary Blake Legal Thrillers and other legal themed novels and children’s books. For more information, please visit https://www.markmbello.com
