We are not alone in the fight to protect Medicaid. Using our vast member strength and standing with our political and community allies, we can win it.

It was entirely predictable. With new leadership in Washington, DC, and “Project 2025” now firmly shaping our national political agenda, the billionaires, the bankers, the hedge funds, the tech oligarchs, and other representatives of the ultrawealthy are working overtime to line their pockets at the expense of everyone else. They are coming for “us”—we who do the work, we who make the goods and provide the services, we who produce the wealth—we who make things run. This is particularly true in the field of healthcare, where threats to Medicaid are mounting quickly. We must use the fullest extent of 1199’s national political clout and our power in numbers to organize a united front and fight back.

Medicaid is our nation’s biggest and most successful healthcare program, providing care to the frail and elderly, low-income families, children, the most vulnerable among us. Medicaid provides about 80 percent of revenues in the home care industry, a majority of nursing home revenues, and—depending on the patient population—30 percent or more of hospital revenues. Which is to say, tens of thousands of our jobs are on the line in this fight.

Under President Joe Biden, enrollment in Medicaid hit a record high—over 70 million people—and the uninsured rate reached a record low. This was great progress. But the leadership now controlling the levers of power in Washington DC are trying to reverse course.

Republicans say they plan to use funding cuts and regulatory changes to dramatically shrink Medicaid. The proposals include rolling back the Affordable Care Act’s Medicaid expansion, which over the last 11 years has added about 20 million low-income adults to its rolls. And why do they say this is necessary? Because they want to extend the 2017 Trump tax cuts for millionaires and billionaires, which are slated to expire at the end of this year. So that’s their desired trade-off: cut off healthcare for sick children, the infirm and elderly, and slash healthcare funding, just so that the Elon Musks, Jeff Bezos, and Mark Zuckerbergs of the world can buy yet another superyacht or another home in Maui.

But this is not a done deal. The fight has just begun. I have built deep relationships over the years with leaders including House Minority Leader Hakeem Jeffries and Senate Minority Leader Chuck Schumer, and I know they will stand in our corner as 1199 builds the broadest possible fightback to defend healthcare funding. Faith leaders including Rev. William Barber and Rev. Jesse Jackson and are with us in this fight. And many stalwart labor leaders, including our SEIU President April Verrett, AFL-CIO president Liz Shuler, American Federation of Teachers President Randi Weingarten, and the millions of members they represent are with us, too.

It is clear where Trump stands and that the Republicancontrolled Congress is, for the most part, ready to do his bidding. But Republican control is only by the barest of margins—and that is thanks to incredible work we at 1199 did in the last election to mobilize voters in key swing districts. If Democrats stand together, House Republicans can only afford to lose two defectors.

Every 1199 region, from Florida to Massachusetts, has one or more Congress members who are vulnerable in their next election. Our job is to make them understand that if they want to remain in office into 2027, they must protect Medicaid.

We have already put Congress members on notice by rallying outside of district offices. But this is just the beginning. Many state governments, hospital systems, long-term care providers, other unions—and everyone who wants to do well by doing good—need Medicaid to be adequately funded, and we must build the broadest possible coalition.

No doubt, Washington DC extremists and their billionaire pals are preparing to wage war against working people, especially healthcare workers like us. But, 1199ers know how to fight and we know how to win. The future of our patients, our jobs, our families, and our country is at stake. Time to put on your marching shoes.