President Donald Trump signed the ‘One Big, Beautiful Bill Act’ into law on the Fourth of July, a bill that will put a burden on rural healthcare.
If nothing is done to the law, starting in 2028, rural hospitals will likely have to eliminate some services they currently provide to rural communities, typically where Indigenous communities are located. The law added Medicaid work requirements, regardless of the job market in their areas and a reduction in the hospital's provider fee program funding.
Native Americans and Alaskan Natives are exempt from the work requirement for healthcare benefits, legislation that pleased John Reeves III, the Indigenous Healthcare Advancements president.
“We’ve been hammered through all legislation, it’s really nice to finally get an exemption,” Reeves said. “It goes back to the trust responsibilities which are really important that sometimes the feds honor or don’t.”
This work exemption doesn’t mean that Indigenous communities won’t be impacted. Tribal clinics offer basic dental, mental health and limited primary care physicians services. It’s common for Tribal members to be referred to go to their nearest hospital from the clinic.
And if hospital services are dropped in the rurals, a referral from a tribal clinic could double the trip to the nearest city.
For members of the Yerington Paiute Tribe, they have the Lyon County hospital which according to the Chairman Ginny Hatch, doesn’t sufficiently meet the emergency room needs for the town and need to be taken to Carson City.
“If you don’t have a vehicle or you don’t have a means of transportation, you may suffer a lot of hardship if you can't use what’s local here,” Madam Chair said. “For a lot of people our tribal clinic is usually the first step before going into the ER.”
If patients need to be taken to a fully operational hospital for an emergency, this will increase the cost due to the need for either air medical services or an ambulance to take them to the city.
This potential cut to services comes at a time where nearly 40 percent of rural hospitals in Nevada in 2024 were at risk of closing their doors, according to the Center for Healthcare Quality and Payment Reform. Although concerned of future impacts, Blayne Osbron, Rural Nevada Hospital Partners President, doesn’t believe any rural hospitals will close in Nevada.
“Here in Nevada we have 14 rural hospitals total, the good news is we don’t have any spare hospitals,” Osbron said. “The bad news is, we can’t afford to lose any of those 14.”
Guest: Blayne Osborn, president of the Nevada Rural Hospital Partners; John Reeves III, president of Indigenous Healthcare Advancements; Ginny Hatch, chairman of the Yerington Paiute Tribe.
