The federal government is looking to cut billions in spending to pay for tax cuts for the wealthiest individuals and corporations. They are open about this. The only way to meet their cutback goals will be to cut Medicaid. The U.S. does indeed spend a lot on health care, and it’s impossible to cut enough without touching Medicaid.

So what would that look like here, for us?

Depending how Massachusetts responded, this could mean that insurance covers less or that people lose coverage altogether. Everyone on MassHealth or a subsidized plan — about 35% of people in Franklin County — is vulnerable.

Two things will happen simultaneously. First, everyone will continue having health care needs but they will defer care, get sicker. Second, medical providers will not receive the dollars they normally earn from serving MassHealth patients. They will cut staff and services. Locations will close.

Next, these two problems mix. People require higher-level care. Emergency rooms fill up. Outcomes are worse and care costs more. When that happens, everyone, even well-insured, wealthy people, will be in trouble. Your heart attack, infection, or injury will not be treated as quickly. Your medical team will be understaffed and exhausted. You will travel further for care. Your health insurance premiums will increase.

The U.S. health care system has real problems now, but it can get so much worse. Now is the time to learn what Medicaid does, before the next budget. Legislators across the country must understand that cuts to Medicaid will harm all of their constituents. Spread the word.

Allison van der Velden

CEO, Community Health Center of Franklin County, Greenfield