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I recently made an early-morning visit to the El Rio Health Center at Congress for a lab test and noticed something that caught my attention: A few working-age men and women, dressed for work, sat in the waiting area for tests. Nothing strange here for those of us who are fortunate to have comprehensive health care coverage. Except, besides being a patient at El Rio, I was the CEO for close to twenty years until leaving in 2004.

During my tenure there I was accustomed to seeing mostly mothers, children, and seniors as patients. They were the segments of the population that the federal Medicaid program began extending coverage to in the 1980s and ’90s. To qualify for Medicaid in Arizona in 1995, working-aged men and women had to earn less than $226 per month as an individual or support a family of four on less than $454 per month. They lacked access to routine care at that time, which many of us now have readily available.

That changed in 2014 when Medicaid, AHCCCS here in Arizona, began providing full-benefit coverage to low-income adults 19 to 64. Over two-thirds of them held regular jobs then and today. Presently, an additional 21 million in the US and 600,000 in Arizona have full-benefit Medicaid resulting from expanded coverage. Who are these fellow citizens (and, yes, one must be a citizen or legal resident to qualify for benefits)? They may be your child’s school bus driver, a caretaker for your elderly relative, or even a family member or neighbor. They are likely to be the head of households for families that live at or near the federal poverty level threshold.

Continuing full-benefit health care coverage for the working poor is in the balance in the current Congress. The budget reconciliation bill passed last week in the House will lead to dramatic reductions in the Medicaid program in the forthcoming federal budget. Coverage for the working poor will suffer the brunt of these changes. No amount of smooth-talking by the Congressional majority will alter the fact that up to one-third of Arizonans on AHCCCS will lose health care coverage automatically by Arizona statute should Congress even slightly change federal Medicaid financing. As the Greek maxim goes, “The strong do what they can and the weak suffer what they must.”

To partially offset tax cuts that accrue disproportionately to the rich, Congress feels compelled to reduce benefits to the working poor while simultaneously painting themselves as responsible guardians of taxpayer dollars. Mr. Ciscomani and Mr. Grijalva, the people of Southern Arizona, are observing your actions and decisions closely. Where will you stand on this crucial decision?

The rest of us are not helpless bystanders to the anticipated hit-and-run. AHCCCS coverage for the 178,000 adult beneficiaries in Southern Arizona eligible because of the expansion of Medicaid in 2014 provides $1.6 billion annually to health care providers in the area. Conservatively, that money funds approximately 12,300 jobs in the local health care industry. Jobs at risk should Congress pass fundamental changes to the program leading to the elimination of coverage for the working poor.

By comparison, if Elon Musk were to fire all the active military and civilian employees at Davis-Monthan Air Base, how would we react as a community? It would be loud and forceful. Cynical politicians can choose to depict eliminating coverage to the working poor as focusing the safety net on less “vulnerable” mothers, children, and seniors as a better way to sell tax cuts to the public. The damage of this Congressional action will extend far beyond the poor households asked to shoulder this burden. Local leaders and the public know better than that. From a personal perspective, the only fraud and abuse I see concerning this issue is the one perpetrated by the Congressional majority.