As Provo’s newly elected mayor and a lifelong Republican, I believe in fiscal responsibility, local control and practical solutions. That’s why it’s important to be clear about this reality: When the federal government cuts Medicaid, our communities become less affordable and less livable for everyone.
The affordability crisis facing Utah families isn’t just about rising housing costs, health care and grocery prices. It’s also about the hidden costs that appear when essential services disappear. When Washington, D.C., cuts Medicaid funding, those costs don’t go away — they are pushed down to cities and counties, and eventually picked up by taxpayers.
Here’s what happens. Counties are legally required to provide mental health and substance abuse services, which are primarily paid for by Medicaid. For example, local programs like Wasatch Behavioral Health (Utah County) and/or Optum Health (Salt Lake County) are able to serve our most vulnerable residents because Medicaid makes that care possible. When Medicaid funding drops — or when eligible people lose access to Medicaid — counties face an impossible choice: raise taxes, cut other services or watch treatment programs collapse. Every option makes life more expensive and less stable for residents.
The math is straightforward. Counties must match at least 20% of state behavioral health funding. When federal Medicaid dollars shrink, our local dollars buy less care. The gap grows quickly, and we can find that it’s our friends, families and neighbors — not just strangers — who are at risk. The impact is felt across our entire community.
When people can’t access mental health care or addiction treatment, we see the results in our communities every day. Families end up in crisis. Domestic violence and homelessness increase. Public spaces become less safe. Businesses struggle and property values decline.
Research shows that Medicaid expansion reduces arrests by 20-32% in participating counties, and drug-related arrests drop by up to 41%. Homelessness declines as well.
Cutting Medicaid at the federal level creates a cascade of problems: more people in crisis, more pressure on police and emergency services, and ultimately higher costs for everyone. Law enforcement becomes the front line for health crises instead of focusing on public safety.
Medicaid isn’t perfect. It needs oversight, accountability and continual improvement. But it is the system we have — and right now, it is far more cost-effective to fund care upfront than to pay later through jails, emergency rooms and social instability.
In Provo, we see firsthand how access to health care and mental health and addiction services helps keep neighborhoods safe, reduces strain on public safety and protects quality of life.
This isn’t just a health policy debate. It’s a public safety issue, a local control issue and a taxpayer issue. Provo residents work hard, pay their taxes and invest in their community. They deserve policies that protect that investment by keeping our city safe, affordable and livable — and that means maintaining responsible Medicaid funding.