In New Letter, Mayors Raise Concern Over Proposed Cuts to Medicaid and Effect on Public Safety in Cities

Bill being considered by the House threatens progress on public safety and homelessness

WASHINGTON, May 9, 2025 /PRNewswire/ -- Today, United States Conference of Mayors (USCM) President Columbus (OH) Mayor Andrew Ginther and USCM CEO and Executive Director Tom Cochran sent a letter to the House Energy & Commerce Committee, calling on its members to preserve and strengthen Medicaid as a matter of public safety. Cuts to Medicaid are currently being considered by Congress that will hurt beneficiaries and jeopardize the progress made on public safety in American cities. Medicaid supports programs that address behavioral health and substance abuse, helping those in crisis connect with providers and keeping police officers focused on violent crime.

The letter reads in part, "Our police officers and EMTs are often the first on the scene when someone is experiencing a mental health crisis, struggling with addiction, or suffering from a preventable health condition that has gone untreated. These are not simply public health issues—they are public safety challenges. Without access to the ongoing care that Medicaid provides, these challenges grow more severe, more dangerous, and more costly for local governments."

Full text of the letter can be found below, and a copy is linked here:

Dear Chairman Guthrie and Ranking Member Pallone: 

We write on behalf of Americaʼs mayors to urge you to preserve and strengthen the Medicaid program, not cut it, as you markup the reconciliation bill. The cuts being considered by Congress will not only hurt Medicaid beneficiaries and our health system, but also jeopardize public safety and the progress we have made in reducing violent crime. As you stand in support of our police during Police Week, please bear in mind that the Medicaid cuts and eligibility changes you are considering will limit the ability of our police officers to focus on violent crime. Medicaid cuts will exponentially increase the instances of officers responding to people suffering from mental health crises, substance abuse addiction, housing instability, and more who otherwise would have had access to healthcare services through Medicaid ensuring their stability. 

We have made great progress in reducing violent crimes over the last few years. A Violent Crime Survey of 68 cities released May 6 by the Major Cities Chiefs Association showed that homicides declined by 20% during the first quarter of 2025 compared with the same period last year. Rape was down 14%,robbery 20%, and aggravated assault 11% in the survey cities. Americaʼs mayors are proud of the decline in crime we have seen and are doing everything possible to reduce crime further in our cities, to make our cities safe.

Our police officers and EMTs are often the first on the scene when someone is experiencing a mental health crisis, struggling with addiction, or suffering from a preventable health condition that has gone untreated. These are not simply public health issues—they are public safety challenges. Without access to the ongoing care that Medicaid provides, these challenges grow more severe, more dangerous, and more costly for local governments. 

In our cities, Medicaid: 

• Supports Crisis Response and Diversion: It funds behavioral health and substance use treatment that help reduce 911 calls, emergency room visits, and jail bookings—allowing police to focus on true public safety threats and reimburses some of the costs of EMT calls.
• Reduces Recidivism: Access to healthcare, especially during reentry from incarceration, reduces the likelihood that individuals will cycle back through the justice system.
• Protects First Responders: Medicaid-funded services help prevent dangerous confrontations by providing community-based care and stabilizing individuals before they reach a point of crisis.
• Stabilizes Families and Neighborhoods: By addressing underlying health and social challenges, Medicaid helps create safer, more resilient communities.

The healthcare, mental health support, substance abuse prevention, and other services provided by Medicaid help prevent and reduce homelessness which has a major impact on public safety. Homeless people are disproportionately victims of crimes and commit crimes at a disproportionate rate. 

Medicaid supports those experiencing homelessness by: 

• Providing access to those with poor health and limited access to care which is a primary cause of homelessness.
• Providing for services that ensure the most chronically homeless are stabilized.
• Supporting medical services that provide much needed healthcare which reduces the economic burden that allows households to afford housing.

If these services are reduced or eliminated, we may well see an increase in homelessness, and that may also lead to an increase in crime. 

Americaʼs mayors urge you to recognize Medicaid as not only a health program, but as a vital public safety tool and to oppose any cuts to Medicaid as you markup the reconciliation bill. Thank you for your leadership and for standing with Americaʼs cities on this critical issue. 

Sincerely, 

Andrew J. Ginther                                                            Tom Cochran
Mayor of Columbus, OH                                                  CEO and Executive Director
President

Cc:  Members, House Energy and Commerce Committee

About the United States Conference of Mayors -- The U.S. Conference of Mayors is the official nonpartisan organization of cities with populations of 30,000 or more. There are more than 1,400 such cities in the country today, and each city is represented in the Conference by its chief elected official, the mayor. Like us on Facebook or follow us on Twitter.

SOURCE U.S. Conference of Mayors