States are cutting Medicaid provider payments long before Trump cuts hit
Source: NPR
October 5, 2025 8:22 AM ET
Every day for nearly 18 years, Alessandra Fabrello has been a medical caregiver for her son, on top of being his mom. "It is almost impossible to explain what it takes to keep a child alive who should be dead," said Fabrello, whose son, Ysadore Maklakoff, experienced a rare brain condition called acute necrotizing encephalopathy at 9 months old.
Through North Carolina's Medicaid program, Maklakoff qualifies for a large slate of medical care in the family's home in Chapel Hill. Fabrello said she works with staffing agencies to arrange services. She also learned to give the care ordinarily performed by a doctor, skilled nurse, or highly trained therapist because she often can't get help.
Now, broad cuts to North Carolina Medicaid will make finding and paying for care even more difficult. Medicaid is government health insurance for people with low incomes or disabilities and both state and federal dollars pay for the program.
Nationwide, states are scrambling to close budget shortfalls and are eyeing Medicaid, generally one of a state's biggest costs — even before President Donald Trump's hulking tax-and-spending law decreases federal spending on Medicaid by about $1 trillion over the next decade.
Read more: https://www.npr.org/2025/10/05/nx-s1-5558321/states-are-cutting-medicaid-provider-payments-long-before-trump-cuts-hit
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