Dying to save a dollar: When conservative policy costs lives by cutting Medicaid, SNAP and other programs
At what point do we stop calling it “fiscal conservatism” and start calling it what it is: a slow, strategic abandonment of our most vulnerable Americans?
Year after year, we see the same headlines: Proposals to slash Medicaid. Efforts to raise the eligibility age for Medicare. Pushback on food assistance. Attempts to repeal the Affordable Care Act with no real alternative. Cuts to critical public health infrastructure-including early warning systems for emergencies like natural disasters and disease outbreaks.
And now, in 2025, some Republican lawmakers are once again calling for drastic cuts to social programs under the guise of balancing the budget.
But here’s the part that should make every American — regardless of party — pause: The people who will suffer the most from these cuts aren’t political abstractions. They are veterans, seniors, single mothers, working-class families, people with disabilities. These are neighbors, not numbers.
Let’s ask the uncomfortable question: Is it a Republican strategy to cut funding so Americans will simply die? To be clear: I’m not accusing GOP leaders of intentionally plotting to kill people. But I am questioning a pattern of decisions that leads, predictably and repeatedly, to lost lives.
The data is undeniable. A 2019 National Bureau of Economic Research study found that an estimated 15,600 additional deaths occurred in states that refused to expand Medicaid under the Affordable Care Act during the program’s first four years.
These weren’t just unfortunate outcomes — they were the direct result of political decisions. Decisions to withhold care. To withhold help.
And that raises an even more chilling thought: If enough poor, elderly and sick Americans die early, the government saves money. Fewer people drawing on Social Security, Medicare, or Medicaid. Less demand for affordable housing, fewer subsidies, fewer safety nets. Less investment in lifesaving infrastructure like emergency early warning systems. In the most cynical view, early death quietly becomes a budget-balancing tool.
Some may find comfort in believing they’re now at peace in the hereafter-but faith calls us to care for life here, too. And yet, the party that campaigns on “pro-life” values seems disturbingly comfortable with policies that let people die once they’re out of the womb and out of luck.
The justifications are familiar: “The debt is too high.” “Government shouldn’t be in the business of health care or public safety.” “We need to promote personal responsibility.”
These statements sound noble until you realize they often come from lawmakers with excellent taxpayer-funded health plans themselves.
Ask yourself: What kind of society pretends there’s no money for insulin or for early warning systems that save lives but gives tax breaks to billionaires? What kind of leadership allows maternal mortality to rise in the richest country on Earth, then shrugs and says the private sector will figure it out?
The Republican Party once called itself the party of life, liberty, and limited government. But when your version of “limited government” means limiting people’s access to care, food, housing, public safety and survival-what you’re really offering is a limited life.
If we are truly a nation that values life — from beginning to end — then we must prove it in how we care for the vulnerable, not just in how we vote. Because death by policy negligence is still death, and no amount of scripture, spin, or sanctimony will ever change that.
We don’t need cruelty disguised as courage. We need courage that includes compassion. Until then, let’s keep asking the hard questions. Because someone’s life may depend on it.
Laura Armstrong of Rapid City, a speech language pathologist who owns a small private clinic, is a regular contributor to The South Dakota Standard. She served two consecutive terms on the Rapid City Common Council (2017-2023) twice as council president, and remains dedicated to the Rapid City community.
Photo: shopping at a farmer’s market that accepts SNAP benefits, public domain, wikimedia commons
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