This commentary is part of TCF’s Beyond Health series, which discusses the many potential harms of up to $880 billion in potential Medicaid cuts across issue areas.
Over the past two months, House Republicans and Donald Trump have gone on a slash-and-burn frenzy across the federal government, taking a blow torch to agencies that provide critical services to Americans nationwide. At the same time, Republicans in Congress have taken special aim at one of the most popular government programs, Medicaid, suggesting $880 billion in cuts over ten years to a program that provides health coverage to over 80 million children, adults, pregnant women, elderly individuals, and people with disabilities.
The people who need Medicaid the most are also the same people that are more likely to be victims of gun violence.
While people often think of Medicaid as a program covering health care for low-income households, particularly children and seniors, its investments and impact goes far beyond them, into the realm of public health and safety when it comes to gun violence prevention. A big reason for this connection comes from the fact that the areas with the highest rates of gun violence in the United States—whether urban or rural—are often areas with populations that disproportionately rely on Medicaid. Said differently, the people who need Medicaid the most are also the same people that are more likely to be victims of gun violence. For example, in Pennsylvania, more than 70 percent of firearm injury patients had government insurance, with Medicaid covering 65 percent of those injured.
Recognizing this connection, the Biden–Harris administration looked to leverage the Medicaid program to help prevent gun violence and protect public health. In October of last year, the Centers for Medicare and Medicaid Services (CMS) announced that states could use Medicaid to pay health care providers for counseling parents and caregivers on firearm safety and injury prevention. The American Academy of Pediatrics found that firearm safety anticipatory guidance provided by a clinician can increase household safe firearm storage behaviors, and the National Institute of Health points to studies that show a modest increase in safe firearm storage would result in a 32 percent decrease in lives lost.
Under the Biden–Harris administration, CMS also authorized health care providers to be reimbursed by Medicaid for violence intervention programs. Community violence intervention programs have been proven to reduce gun violence in the communities across the country. Several states, including California, New York, and Colorado, have passed legislation to take advantage of this funding through hospital-linked violence intervention programs.
From California to Pennsylvania, these programs have seen reductions in gun violence. For example, Operation Peacekeeper Fellowship in California was associated with 55 percent fewer deaths and hospital visits, and 43 percent fewer crimes related to firearms. On the east coast, Operation Ceasefire in Boston was associated with a 63 percent reduction in youth homicide victimization. However, programs like the At-Risk Intervention and Mentoring in Denver are beginning to feel squeezed in the face of pending Medicaid cuts. And in March 2025, the Trump administration rescinded previous guidance on Medicaid support for health-related social needs, which likely targets these programs.
Zooming out from these gun violence centered approaches, there are a number of other services that Medicaid provides that have downstream benefits when it comes to gun violence prevention. For starters, Medicaid is the single largest payer for mental health services in the United States. In 2023, 58 percent of all gun-related deaths in the United States were suicides. With suicides representing the leading cause of gun violence, the results of slashing critical mental health benefits for the people who need them most could be devastating. As with mental health care, Medicaid is also the largest single source of insurance coverage for drug and alcohol treatment in the United States. Cuts to Medicaid would likely have a negative impact on those currently experiencing crises of addiction—crises that are all the more deadly when guns are involved.
Although President Trump and his Department of Health and Human Services removed the former surgeon general’s warning declaring gun violence a public health crisis, this does not change the reality that, in 2023, 47,000 people died from gun-related injuries in the United States alone. This could increase if the president and Congress decide to strip $880 billion in health care away from the most vulnerable among us in order to finance a tax cut skewed toward the wealthiest.
Tags: gun violence, gun safety, medicaid cuts, beyond health, medicaid, gun control
Beyond Health: Medicaid Cuts Will Further Exacerbate the Epidemic of Gun Violence
This commentary is part of TCF’s Beyond Health series, which discusses the many potential harms of up to $880 billion in potential Medicaid cuts across issue areas.
Over the past two months, House Republicans and Donald Trump have gone on a slash-and-burn frenzy across the federal government, taking a blow torch to agencies that provide critical services to Americans nationwide. At the same time, Republicans in Congress have taken special aim at one of the most popular government programs, Medicaid, suggesting $880 billion in cuts over ten years to a program that provides health coverage to over 80 million children, adults, pregnant women, elderly individuals, and people with disabilities.
While people often think of Medicaid as a program covering health care for low-income households, particularly children and seniors, its investments and impact goes far beyond them, into the realm of public health and safety when it comes to gun violence prevention. A big reason for this connection comes from the fact that the areas with the highest rates of gun violence in the United States—whether urban or rural—are often areas with populations that disproportionately rely on Medicaid. Said differently, the people who need Medicaid the most are also the same people that are more likely to be victims of gun violence. For example, in Pennsylvania, more than 70 percent of firearm injury patients had government insurance, with Medicaid covering 65 percent of those injured.
Beyond Health
Read more about what deep Medicaid cuts would mean for everyday Americans.Beyond Health: Medicaid Cuts Would Bring Widespread Harms to Americans
Beyond Health: Potential Impact on Foster Youth of $880 Billion in Medicaid Cuts
Beyond Health: What Cutting Medicaid Means for Disabled People, Including in Maine
Beyond Health: Medicaid Cuts Will Further Exacerbate the Epidemic of Gun Violence
Beyond Health: Potential Impact on K–12 Students of $880 Billion in Medicaid Cuts
Beyond Health: Medicaid Cuts Could Put College Dreams on Life Support
Beyond Health: Threats to Medicaid Funding Would Endanger Child Care Too
Recognizing this connection, the Biden–Harris administration looked to leverage the Medicaid program to help prevent gun violence and protect public health. In October of last year, the Centers for Medicare and Medicaid Services (CMS) announced that states could use Medicaid to pay health care providers for counseling parents and caregivers on firearm safety and injury prevention. The American Academy of Pediatrics found that firearm safety anticipatory guidance provided by a clinician can increase household safe firearm storage behaviors, and the National Institute of Health points to studies that show a modest increase in safe firearm storage would result in a 32 percent decrease in lives lost.
Under the Biden–Harris administration, CMS also authorized health care providers to be reimbursed by Medicaid for violence intervention programs. Community violence intervention programs have been proven to reduce gun violence in the communities across the country. Several states, including California, New York, and Colorado, have passed legislation to take advantage of this funding through hospital-linked violence intervention programs.
From California to Pennsylvania, these programs have seen reductions in gun violence. For example, Operation Peacekeeper Fellowship in California was associated with 55 percent fewer deaths and hospital visits, and 43 percent fewer crimes related to firearms. On the east coast, Operation Ceasefire in Boston was associated with a 63 percent reduction in youth homicide victimization. However, programs like the At-Risk Intervention and Mentoring in Denver are beginning to feel squeezed in the face of pending Medicaid cuts. And in March 2025, the Trump administration rescinded previous guidance on Medicaid support for health-related social needs, which likely targets these programs.
Zooming out from these gun violence centered approaches, there are a number of other services that Medicaid provides that have downstream benefits when it comes to gun violence prevention. For starters, Medicaid is the single largest payer for mental health services in the United States. In 2023, 58 percent of all gun-related deaths in the United States were suicides. With suicides representing the leading cause of gun violence, the results of slashing critical mental health benefits for the people who need them most could be devastating. As with mental health care, Medicaid is also the largest single source of insurance coverage for drug and alcohol treatment in the United States. Cuts to Medicaid would likely have a negative impact on those currently experiencing crises of addiction—crises that are all the more deadly when guns are involved.
Although President Trump and his Department of Health and Human Services removed the former surgeon general’s warning declaring gun violence a public health crisis, this does not change the reality that, in 2023, 47,000 people died from gun-related injuries in the United States alone. This could increase if the president and Congress decide to strip $880 billion in health care away from the most vulnerable among us in order to finance a tax cut skewed toward the wealthiest.
Tags: gun violence, gun safety, medicaid cuts, beyond health, medicaid, gun control