The Friday before Mother’s Day has been claimed as National Child Care Provider Day—a moment to express appreciation to workers whose time spent with children is second only to parents.

Child care facilities across Richmond will put up signs and offer baked goods. What many will not offer: A living wage or affordable health insurance.

As expensive as child care is for parents, the true cost is even higher than parents may know. We are the beneficiaries of Medicaid when its existence allows these institutions to pay bottom-of-the-barrel wages—where about a quarter of Virginia’s child care workers access their health care through Medicaid. In turn, Medicaid coverage allows child care workers to receive quality medical care so they can provide arguably one of the most important roles in our communities: caregiving.

Despite Medicaid’s crucial role as the invisible glue behind child care (and the other systems run by the 74 million Americans who rely on insurance through Medicaid) there is a wide gap in understanding between the secondary beneficiaries and those who rely on it directly. Guess which demographic is more likely to be roaming Congress?

Throughout those halls, references to Medicaid fraud and waste make their way into talking points, echoing the “welfare queen” slur-as-narrative that took shape in the Reagan era—imaginary Poor Americans illicitly pocketing thousands of dollars in health care. In reality, Medicaid fraud is low.

And yet, the doomsday moment has arrived.

In the coming days, the U.S. House Committee on Energy and Commerce will be reviewing how to cut $880 billion in federal spending over the next decade. The nonpartisan Congressional Budget Office has confirmed this would require deep cuts to Medicaid. The recently passed budget reconciliation instructs Congress to cut enough to continue to fund 2017 tax cuts.

“(These are) tax cuts that disproportionately benefit the wealthy and actually add $2 trillion to the national debt over the next 10 years,” says Victoria Richardson, a health care and public benefits attorney for the Center for Healthy Communities at the Virginia Poverty Law Center. Richardson joins advocates across the country in the fight to preserve funding during this vulnerable time.

She has watched these moves both as a parent and in her role at VPLC. Among the cascading consequences of these cuts would be a child care framework pushed further to the brink.

In the coming days, the U.S. House Energy and Commerce Committee will be reviewing how to cut $880 billion in federal spending over the next decade. The nonpartisan Congressional Budget Office has confirmed this would require deep cuts to Medicaid.

Fortunately, she says, Medicaid expansion has resulted in increased rates of insurance among child care workers. Many child care centers are small businesses that struggle to afford the cost of providing health insurance to their employees. Without access to Medicaid, workers will be pulled to other roles where they can find the health care they need. And that’s just one element of parents’ village that will be affected.

“The impact of the House budget reconciliation becoming law would be catastrophic. These cuts will impact Virginia families significantly,” Richardson says. “Even those that are not Medicaid enrollees, by indirect harms.”

Virginia’s “trigger law” means that if the federal contribution drops, Medicaid expansion will cease. That would mean the disenrollment of some 630,000 Virginians who use Medicaid.

Like so many of us, Richardson’s family relies on child care workers. She wants to see systems improve, not further degrade.

“I think a lot of parents are frustrated,” Richardson says. “We appreciate our daycare workers so much and they deserve to get paid more but, as it is, our child care expenses are nearly as much as our mortgage.

“The child care crisis is very real,” she adds. “I fear that losing Medicaid funding, especially for the Medicaid expansion population, could lead to greater instability in the day care workforce.”

So on this holiday, a card is nice, writing to Congress would be even better. None of this would fix the fact that child care workers should be among the highest paid professionals in Richmond, but it’s a start.

We want to hear from you about your experience with Medicaid for a future column—please share with us here.

Catherine MacDonald is a local parent and gerontologist who studies growing up in modern society as part of her job at Virginia Commonwealth University (though her views expressed do not represent her employer). Her husband Tom Nash is a former Style Weekly reporter and proxy for FOIA nonprofit MuckRock. They share writing duties for the On Parenting column.