Medicaid Cuts and Lottery Dreams: America’s Rigged Gamble

Tonight, the Powerball jackpot stands at an astounding $1.8 billion, the second largest in U.S. history, with a lump sum cash option of roughly $826 million. Gas stations are buzzing, office pools are swelling, and the media is salivating over the spectacle of someone, somewhere, holding a giant check.

But while millions line up for a one-in-292-million shot at salvation, a different game of chance is playing out in Washington. The One Big Beautiful Bill (H.R.1) is stripping millions of Americans of Medicaid coverage, dismantling rural hospitals, and slashing the very safety nets that stand between survival and collapse. The irony is unbearable: we are sold billion dollar fantasies while the lifelines that actually keep us alive are being quietly shredded.

The Math That Destroys the Fantasy

Let’s strip the glitter off the jackpot. The odds of winning thePowerball are 1 in 292.2 million, while Mega Millions hovers at 1 in 302.6 million. To even have a 50 percent chance of winning once, you would need to buy nearly 300 million tickets. At $2 a ticket, that’s almost $600 million spent for a coin toss at a single jackpot. Mathematically, the expected value of a ticket is always negative. You are paying for a fantasy. And if you think you’re the exception, remember: you are more than 200 times more likely to be struck by lightning this year than to win tonight’s drawing.

The Numbers Speak: Losing Health vs. Betting on Luck

Here’s the colder truth. Americans spent over $113.3 billion on lottery tickets in 2024, averaging about $350 per person in states with lotteries, and that figure is climbing in 2025. Meanwhile, healthcare is devouring household budgets. Marketplace premiums now average $621 per month for a Silver plan in 2025, a seven percent increase over 2024. Individual plans range between $380 and $540 per month, depending on tier. For families, the burden is crushing: the typical U.S. household now spends over $2,026 per month on insurance related costs, before surprise medical bills.

When Medicaid is stripped away, the picture is even harsher. A single adult faces premiums around $432 per month, while a family of three may confront costs exceeding $1,100, conservative figures that underestimate the true squeeze. For households already living paycheck-to-paycheck, these numbers aren’t just high. They’re catastrophic.

Lottery as a “Voluntary Tax”

Economists often call the lottery a voluntary tax, but that phrase is almost too polite. Like taxes, lottery revenue funds state programs such as education, infrastructure, and social services. Unlike taxes, it is regressive: lower income households spend a far greater share of their income on tickets than wealthier ones. And unlike taxes, the house always wins. Odds are designed so that the state’s take is predictable, and profit is baked into the system.

The difference lies in the framing. Taxes feel mandatory and resented. Lottery tickets feel like choice, fun, and possibility. That illusion transforms a guaranteed financial loss into a sliver of imagined opportunity. It’s state-run sleight of hand, and it works.

Psychological Traps That Keep Us Playing

Why do people keep playing when the math is so brutal? Because the brain itself is biased toward false hope. The gambler’s fallacy tells us that years of playing mean we are “due.” The illusion of control convinces us that birthdays and lucky numbers give us influence over randomness. The near-miss effect makes being one number away feel like a sign of inevitability. And optimism bias persuades us that we’re special, that lightning will strike us, not the other 292 million players.

A $2 ticket isn’t just a gamble. It’s a psychological drug, a daydream injection. It buys mental real estate where we imagine quitting our jobs, buying our parents a house, or finally escaping the grind. For a moment, powerlessness is replaced by infinite possibility. That is why people who can least afford to play, play the most. It is not stupidity, it is survival.

Who Really Buys the Tickets?

The demographics are clear: lottery participation skews heavily toward lower income, less educated populations, the same groups most reliant on Medicaid. Lottery ads saturate convenience stores, bus stations, and corner shops in working class neighborhoods. Jackpots become communal events, amplified by news anchors, workplace chatter, and social media hype.

The cultural script frames the lottery as a legitimate path to the American Dream, but the dream itself isn’t being funded. Education programs receive only a fraction of the revenue, while healthcare systems collapse under funding cuts. The money is funneled upward, siphoned from the many into state coffers and the hands of a lucky few.

The Medicaid Parallel: False Hope vs. Real Loss

While Powerball dangles billion dollar fantasies, the One Big Beautiful Bill is tearing healthcare away from real people. Nearly 16 million Americans have been disenrolled from Medicaid since the unwinding began in the spring of 2023. With those numbers continuing to rise in 2025 due to new work requirements, six-month eligibility checks, and reduced subsidies. Rural hospitals are collapsing, with more than 300 at risk of closure and 700 more vulnerable. Families are being forced to choose between healthcare, rent, and food.

The cruel irony is that the same states marketing lottery tickets most aggressively are often the ones dismantling Medicaid access most ruthlessly. The state sells fantasy with one hand and strips reality with the other.

The Rigged Game

Here’s the kicker: most people know the lottery is rigged. But so is everything else. Jobs underpay and overwork. Healthcare bankrupts families. Student loans crush futures. Housing devours paychecks. In a world where every system feels stacked against them, the lottery becomes the only rigged game where people believe they still have a sliver of a shot.

It’s not stupidity. It’s not irresponsibility. It’s survival in a system that sells hope as a product and bills it as entertainment.

Where Do We Go From Here?

The solution isn’t to shame people for buying tickets. The solution is to build real alternatives. Mutual aid healthcare networks can pool resources for families in need. Cooperative insurance models can prioritize people over profit. Citizens can demand transparency in both lottery allocations and Medicaid policy. And culturally, we can reframe the lottery not as harmless fun, but as what it is: a regressive tax on desperation.

Imagine if even a fraction of the $113 billion spent on lottery tickets each year were redirected into real healthcare. Every ticket not bought is a statement. Every dollar not wagered can be invested in the collective.

The Real Jackpot

Hope is not the problem. False hope is. We don’t need billion dollar jackpots to dream, we need policies that make healthcare accessible, wages livable, and dignity non-negotiable. We need to stop selling survival as a raffle prize.

The One Big Beautiful Bill may have gutted Medicaid, but it also lit a fire. It revealed how fragile the system is, how cynically hope is packaged, and how urgently we must build alternatives. Because the real jackpot isn’t won in a gas station line. It’s built in communities that refuse to play by rigged rules.

Power to all, not to the Powerball