On July 4th, President Trump signed the so-called “One, Big Beautiful Bill Act” and its $880 billion worth of Medicaid cuts into law. Of those, in the next five years, $60 million in cuts are set to hit Nevada Medicaid — the program that provides health insurance to one in four (or about 800,000) Nevada residents, many of whom are low-income, pregnant or disabled.
The legislation also imposes new work, school or volunteer requirements on recipients, to the tune of at least 80 hours per month. Experts caution these requirements will cause an estimated 98,000 Nevadans to lose Medicaid coverage over the next decade.
These funding changes may be felt most acutely in rural corners of the state, as remote hospitals suddenly become unable to turn profits. “About 50% of rural hospitals in the U.S. are operating in the red, meaning they are not turning a profit,” said Jazmin Orozco Rodriguez, a correspondent for KFF Health News. “[They’re] vulnerable to closure.”
That means fewer options for emergency services, labor and delivery care, and just about everything else.
“When you're thinking about someone who lives in Elko, for example, though there is a hospital here — and there is a labor and delivery service still at our hospital — I know of many women in the community who I've met, who drive three-and-a-half hours to Salt Lake City, three hours to Twin Falls, four hours to Boise, four hours to Reno,” Rodriguez said.
Beyond the public health problems that arise with a widespread loss of health insurance, the new work requirements also place an extra burden on the state to staff review boards, which will cope with a new influx of paperwork.
“To the extent that the state will now be expected to do those determinations every six months, rather than every year, that places a new burden in workload on the state to process those applications,” said Pierron Tackes, director of health and social policy for the Kenny Guinn Center for Policy Priorities.
In the meantime, the tax and spending bill also included a rural health transformation program, an abatement measure which will attempt to provide a funding buffer for rural hospitals.
“It was a tip-off that the authors of this legislation absolutely knew that this would destabilize rural health care systems in Nevada and elsewhere in the country,” said John Packham, associate dean in the Office of Statewide Initiatives at UNR’s School of Medicine.
The program provides $50 billion to fill the funding gap, and additional legislation has already been introduced to double that number. Even then, Packham said, it might still fall short of saving some rural communities’ healthcare.
“There are experts suggesting that $100 billion is not going to be enough.”
Guests: Jazmin Orozco Rodriguez, correspondent, KFF Health News; John Packham, Associate Dean in the Office of Statewide Initiatives, UNR School of Medicine; Pierron Tackes, Director of Health and Social Policy, the Kenny Guinn Center for Policy Priorities
