Rural health leaders are concerned about proposed federal cuts to Medicaid

Nebraska’s health leaders are concerned about proposed cuts to Medicaid laid out in Congress’ budget reconciliation bill, also called the “Big Beautiful Bill.”

The more than 1,000-page bill covers many things, one being cuts to Medicaid. Rural health leaders said that it will cost 110,000 Nebraskans their health insurance, as well as 5,000 Nebraskans their jobs, citing a report done by the University of Nebraska Medical Center’s College of Public Health. Within the report, the largest concern was for rural heath care.

During a Zoom meeting put on by the multi-state organization United Today Stronger Tomorrow, the leaders spoke about how tenuous Nebraska’s rural health care system already is.

*In any given year, approximately 50% of our hospitals are going to operate at a negative margin, with 10-20% of those hospitals operating at a negative margin for greater than three years, making them prime for closure,” said executive director for the Nebraska Rural Health Association Jed Hansen.

Hansen said with the added stress from Medicaid cuts, the closures are imminent

"We currently have six hospitals that that we feel are in a critical financial state, three that are in an impending kind of closure or conversion over to the rural emergency hospital model,” Hansen said. "We would likely see the closures within a year to two years of once [the bill is] fully enacted.”

On the call was Tyler Sherman, who is an advanced practice registered nurse with Webster County Community Hospital in Red Cloud. He said Medicaid is a major component in the budget of hospitals like his.

"With the Medicaid cut, these rural hospitals that are already working at a loss likely will be closed within 24 months of the of the shutdown for the Medicaid funding,” Sherman said. “And with the closure of the rural hospitals, patients are going to need to travel further for their care. This includes lifesaving services. So if you call the 911 with a heart attack, it's going to be 45 minutes to 50 minutes before you get to the nearest hospital that's open, versus five minutes with Webster County Hospital.”

These rural hospitals are often large employers for the county as well.

“With the hospital [potentially] closing down, there be loss of jobs, loss of tax revenue for the county and for the community,” said Sherman.

There are worries that with these cuts, the state will have to make up for the losses in the medical sector with cuts to other sectors such as education. Rebecca Firestone, the executive director of the Open Sky Policy Institute said that overall, it is estimated that the cuts will hurt the state’s economy.

“We estimate that these cuts to Medicaid will hurt Nebraska's economy, leading to losses in state gross domestic product of $477 million per year at full implementation of the bill, Nebraska is not alone,” Firestone said.

The senate’s goal is to pass the bill by July 4.