As Congress continues its budget negotiations, Medicaid has emerged as a hinge point. Republican lawmakers remain adamant that any budget deal will not touch Medicaid, the single largest health insurer in the nation. However, reports suggest it will be difficult to achieve the proposed spending reduction goals without taking a significant chunk out of the program.
It is imperative that leaders in Washington slow down, look for other savings and carefully consider all the ways that Medicaid cuts would hit working-class Americans and at-risk households from coast to coast.
More than 72 million vulnerable Americans are insured through Medicaid, including more than 338,000 Utah residents. These are lower-income earners, children, people with disabilities and seniors in long-term care. Many have few to no other insurance options and generally cannot afford costly private plans. In rural Utah specifically, more than one in 10 adults and one in five children count on Medicaid for their health coverage.
This issue is deeply personal for me and my family. In 2021, as my wife and I were expecting our third son, he was diagnosed with Bilateral Renal Agenesis (BRA), a rare congenital disorder where the baby’s kidneys do not develop. It is widely considered a fatal condition with no treatment options. But we were fortunate. We were accepted into a clinical therapy trial. It was a long shot, but it offered our unborn son a chance at survival.
The road was long and arduous. The treatment required us to temporarily relocate from Utah to California. My wife received weekly infusions during her pregnancy. For months after our son was born, he battled for his life in the NICU. He contracted a serious infection, underwent multiple high-risk surgeries and experienced seizures. Even after he was finally able to go home, there were multiple emergency readmissions, made even harder by our rural location. During one of these emergency visits, we did not expect him to pull through.
Yet by the grace of God and the extraordinary care of our physicians and medical teams, my son has defied the odds. He is now three years old. But our family’s journey is not yet finished. My son is on the kidney recipient list in several regions. He will become just the third male BRA survivor to receive a kidney transplant when we get that long awaited call.
Without Medicaid, these life-saving treatments would have been financially impossible. There is absolutely no way we could have covered the costs on our own. It not only covered the cost but also provided in-home nursing care for his ongoing needs, which has improved my son’s quality of life dramatically. And in this way, our story is not unique. So many families insured by Medicaid could have to make difficult, life-altering decisions if Congress slashes funding.
The human element aside, policymakers must also consider the economic impact of slashing Medicaid. Currently, federal funding reimburses three-quarters of our state’s Medicaid spending, which totaled about $3 billion in 2023. If Washington D.C. fails to meet its commitment, Utah could face a huge budget gap that could force state lawmakers into a decision between raising taxes, spending less on other important programs or directly cutting Medicaid benefits.
Medicaid cuts would impact all Utahns because of their effects on our local hospitals. As the executive director of the Rural Health Association of Utah, I can attest that rural providers already face enormous challenges. Rural hospitals receive fewer patients, more of whom tend to be uninsured, which drives up the costs of delivering care. Nationally, fully a third of rural hospitals are already at risk of closing. Cuts to Medicaid would lead to further financial strain and limit rural communities’ access to healthcare.
Medicaid accounts for more than 15% of Utah hospitals’ revenue. Many could be forced to eliminate services or even close if Congress muscles ahead with painful cuts. Residents would bear the burden with even longer drives to get care and longer waits to see a doctor.
I encourage leaders in Congress to slow down and carefully consider what cutting Medicaid would mean for hard-working residents in Utah. It can be a matter of life and death. It was for our family.