The following was adapted from a March 2026 speech that Rose Roach, National Coordinator for the Labor Campaign for Single Payer, gave to the Minnesota AFL-CIO. In July 2025, President Trump signed HR1 into law, inflicting a trillion dollars of federal cuts on our nation’s lifesaving state-based Medicaid programs. Meanwhile, Congress allowed the tax credits available for people enrolled in Affordable Care Act (ACA) insurance exchanges to expire. These cuts impact all of us, even those with union-negotiated health care plans.