How Dare We Not: On the Feminist Future of Care 

As Medicare and Medicaid turn 60, defending care is not just a policy fight—it’s a feminist demand for dignity, democracy and survival.

This essay is part of an ongoing Gender & Democracy series, presented in partnership with Groundswell Fund and Groundswell Action Fund, highlighting the work of Groundswell partners advancing inclusive democracy. You’ll find stories, reflections and accomplishments—told in their own words—by grassroots leaders, women of color, Indigenous women, and trans and gender-expansive people supported by Groundswell. By amplifying these voices—their solutions, communities, challenges and victories—our shared goal is to show how intersectional organizing strengthens democracy.

Later this month, on July 30, Medicare and Medicaid turn 60. 

The anniversary probably won’t receive much celebration, not even a decent sheet cake at Costco. But for those of us who’ve ever been sick, broke or chronically both—and let’s be real, that’s most of us—these two programs are more than government policies. They are lifelines. Feminist infrastructure. Miracles wrapped in red tape. 

Built through decades of organizing—led by Black, poor and disabled women, caregivers and girls who had no choice but to figure it out—Medicare and Medicaid have held our communities together when nothing else would. 

They are the reason elders are still housed, children are still getting care, and some of us are still breathing. They are the soft “yes” behind every grandmother getting her meds, every disabled teen finally receiving a wheelchair that fits, every woman who put her own health on hold until the paperwork finally went through. They are the government’s half-hearted whisper of “okay, fine, you can live,” buried under broken fax machines and six hours of hold music—and still, they are miraculous. 

So it’s no coincidence that these programs are under fire. Again. 

Republicans’ economic plan, which guts Medicaid and Medicare as we know them, is a blueprint for devastation. It slashes benefits, denies care to millions, and decimates access for the very people these programs were built to protect. 

The cruelty isn’t incidental. It’s the point. 

This new law is part of a coordinated, multi-front assault: cutting Medicaid rolls, stoking fear about Medicare’s future, resurrecting racist “work requirements,” and targeting care access state by state. In 2023 alone, over 20 million people—children, elders, pregnant people, entire families—were dropped from Medicaid. Many lost this critical lifeline simply because they missed a letter, or were unable to navigate a glitchy portal fast enough. 

This isn’t reform. This is a quiet culling. 

For example, Georgia’s Medicaid “expansion” requires 80 hours a month of work or volunteering; as if caregiving isn’t work, as if managing a chronic illness is effortless, as if jobs are just waiting for every poor person who asks nicely. These policies aren’t about helping anyone. They’re about shaming, surveilling and punishing people—especially Black women, disabled folks, trans people and single moms—for needing care in the first place. 

Let’s be clear: These cuts aren’t just about budgets. They make up a narrative rooted in racism, ableism, misogyny and a deep disdain for working-class survival. 

Medicare and Medicaid wouldn’t exist in their current form without the Black freedom struggle. In the 1960s, hospitals were still segregated, and Black patients were regularly denied care. But organizers, including Black women, doctors and civil rights leaders, pushed the federal government to tie Medicare funding to hospital desegregation. They won. Medicare became an undercover civil rights bill, along with Medicaid. 

For many marginalized individuals and communities, these programs are the only thing between us and nothing. They are how we survive systems that treat our bodies as disposable, our labor as expected, and our pain as imaginary. 

And yet, we’re still here—filing the paperwork, chasing the specialist, calling again and again. We are constantly feminizing survival: turning scarcity into solidarity, bureaucracy into art, and emergency into everyday mutual aid. 

But survival shouldn’t be the bar. These programs weren’t handed down out of charity. They were won through protest, litigation, sit-ins and fed-up mamas who believed their children deserved care. 

The truth is the fight for care is at the heart of the fight for democracy. 

The same forces attacking abortion access, trans healthcare, public education and voting rights are dismantling the last pieces of this country’s care infrastructure. Why? Because they know what we know: Care is democracy. Mutual aid is power. Interdependence isn’t weakness; it’s how we survive. 

Medicaid and Medicare are not “the least we can do.” They’re some of the most radical things we’ve done. They’re feminist, not because they’re perfect, but because they’re possible. They are public repairs. A clumsy, partial attempt to right some of this nation’s wrongs. 

And now, in their 60th year, these essential programs don’t just deserve celebration. They deserve defense. 

So let’s get to work with petitions, protests, poetry and better policy. When we fight for these programs, we’re not begging for scraps. We’re demanding infrastructure for care. We’re saying, Our dignity is not a rounding error. We are not too complicated or too expensive or too much. We are exactly the point. 

Happy birthday Medicaid and Medicare, the baddest Leos in American policy—dramatic, protective, always carrying us all on their backs while being called “too much.” We see you. We need you. And we’ll fight for you. 

How dare we not?