Making Coercion Backfire: A Guide for Responding to the Medicaid Funding Freeze
This guide is based on the 5 R’s framework from Harnessing Our Power to End Political Violence (HOPE)
When a regime uses the suffering of vulnerable people as political leverage, it is committing an act of political violence, not with guns, but with policy. The goal is to inflict enough pain on a target population that a state government submits to federal demands. But like all forms of political violence, coercion of this kind can be made to backfire and damage the perpetrators more than the targets. Research shows that this doesn’t happen automatically. It happens when people organize deliberately around five principles.
1. REVEAL
Injustice only backfires when people know about it.
The administration is counting on this looking like a technical dispute about Medicaid accounting. Your job is to make visible what is actually happening: elderly people in nursing homes facing care disruptions, people with disabilities losing home health services, providers going unpaid, families in crisis.
What to do: Document everything, starting now. If you work in a nursing home, disability services agency, or healthcare provider organization, create a systematic log of every service disruption, delayed payment, staffing reduction, and individual harm that results from the freeze. Collect testimony from affected people and families in their own words, on video when possible. Ensure that cameras, reporters, and documentarians are present at every public action. Share documentation with legal teams, journalists, and advocacy organizations simultaneously. The evidence must be credible, specific, and widely distributed. Don’t wait for someone else to tell the story.
2. REDEEM
Counter devaluation by humanizing the people being harmed.
The administration’s narrative frames Medicaid recipients as a cost center, as collateral in a fraud dispute, not real people with real lives. Oz and Vance talk about “scoundrels” and “taxpayer money” precisely to create social distance between the public and the people being harmed. Your job is to collapse that distance.
What to do: Center the stories of real people. A ninety-year-old veteran in a nursing home in Duluth. A young woman with muscular dystrophy whose home care aide is the reason she can live independently. A working mother whose children’s healthcare depends on Medicaid. Put names, faces, and life stories in front of the public. Have trusted voices including doctors, nurses, clergy, veterans’ organizations, and employers speak on their behalf. Anticipate the administration’s devaluation tactics: they will call recipients “fraudsters” or link them to immigrant communities. Prepare spokespeople and surrogates who can inoculate the public against these frames before they take hold.
3. REFRAME
Don’t let the perpetrators define what this is about.
The administration wants this to be a story about fraud. It is not. It is the use of vulnerable people’s survival needs as political leverage against a democratic state government. Every communication should make this clear.
What to do: Never accept the frame that this is a “fraud dispute.” Name what it is every time: the federal government is holding elderly and disabled Minnesotans hostage to punish the governor. Document the impact of the freeze, not in dollars, but in human consequences, to neutralize the perpetrators’ narrative. Make clear that Minnesota was already prosecuting fraud aggressively (300+ convictions) and that the administration provided no detailed evidence of the Medicaid-specific fraud it claims to be targeting. Communicate who is accountable: not the governor, not the state, but the specific federal officials - Vance, Oz, and Trump - who chose to withhold funding that 1.2 million people depend on.
4. REDIRECT
Don’t let official channels absorb all the energy.
The administration has structured this to channel everything into a bureaucratic compliance process - the “corrective action plan” - that it controls completely. CMS is the judge, jury, and executioner. The administrative hearing will be conducted by CMS’s own officer. This process is designed to slow things down, demobilize public outrage, and give the appearance that the system is working while people suffer.
What to do: Support the legal challenges and maintain public mobilization. Do not let the court case or the administrative process become a reason to stop organizing. Use the institutional process as a campaigning tactic. Every hearing date, every filing, every ruling is an opportunity to mobilize. Launch parallel processes: public hearings organized by community coalitions, independent documentation projects, cross-state coordination with other targeted states. Make demands of the official process: transparency, timelines, independent arbitration. The legal fight matters, but it cannot be the only fight.
5. RESIST
Don’t be silenced by threats or rewards.
The administration will escalate. It has already signaled that the freeze could grow to $1 billion. It will target other states. It may threaten individual providers, organizations, or officials who speak out. Oz’s instruction to “call your governor” is itself a form of pressure, redirecting public anger away from the perpetrators.
What to do: Prepare for intimidation now. Warn allies, partners, and colleagues that pressure may come. Develop plans for making any threats or retaliation public immediately. Be vocal about your preparedness. When perpetrators know that silencing tactics will be documented and publicized, those tactics become riskier to deploy. Every escalation by the administration is an opportunity for more backfire, but only if you are organized and ready.
Learn more and access training at endpoliticalviolence.org