A sweeping budget bill that has passed the U.S. House and is pending in the Senate could lead to hundreds of billions of dollars in Medicaid cuts. Supporters of the One Big, Beautiful Bill Act say the changes will reduce waste and increase work requirements.
But in rural regions like Colorado’s Four Corners, where access to care is already limited, health care workers and patients worry the bill could take a serious toll.
The bill would make around $600 billion in cuts to Medicaid. The nonpartisan Congressional Budget Office estimates that this could result in nearly 11 million people losing their coverage over the next decade. Advisors to President Trump have addressed the threat by saying the cuts would target undocumented immigrants and able-bodied people.
Russell Vought, of the United States Office of Management and Budget, spoke on CNN in early June about proposed cuts.
“We have illegal immigrants on the program,” said Vought. "We have able-bodied working adults that don't have a work requirement that they would have in TANF or even SNAP.
According to the nonprofit research group KFF, a nonprofit research group, undocumented immigrants aren’t eligible for Medicaid, though hospitals can receive limited reimbursement for emergency care. Colorado recently expanded health coverage to immigrants regardless of legal status, aiming to reduce the long-term cost of relying on emergency services.
In the Four Corners, health care providers and Medicaid recipients face unique challenges, such as the high cost of living and limited access to specialists.
In Colorado’s Third Congressional District, which covers most of the southern and western part of the state, almost one in three people are on Medicaid, and nearly half of all children in the district are enrolled in the program.
Stacy Reuille-Dupont is a clinical and somatic psychologist in Durango.
“The cost of living is so high because many people just struggle to live here," said Reuille-Dupont. "There are a lot of people who are on Medicaid. If you're on Medicaid, you qualify for something because other areas of your life are difficult. Either it's financial, or you've got some sort of chronic illness."
"Poverty, in and of itself, is a traumatic experience in our nervous system, because people are struggling just to survive and just to get enough food, to have the right shelter, to be in places and spaces that are safe."
When people lose Medicaid, it’s not just about losing access to a doctor’s visit or a prescription. It adds another layer of stress to lives already defined by instability.
“Watching the speed at which some of these systems are being dismantled is really concerning,” said Reuille-Dupont. "If we start cutting Medicaid services haphazardly, we're going to impact these different family systems in our community that are already in a survival mode. It hits their partners, it hits the children, it hits the teachers. It hits the school systems, it hits people like me."
Josh Neff is the president of Common Spirit Mercy Hospital in Durango, Colorado. He said that even as Mercy is the largest hospital in the region, it still relies heavily on Medicaid to keep critical services running.
“18% of our total patients we serve at Mercy have Medicaid, Neff explained. "We're just a small hospital in a rural community that's five hours in any direction away from the next largest healthcare system or hospital. We cannot be all things to all people. We try to be the most that we can be to serve the region. If you think about the hospitals in the smaller towns that are around us, they could potentially be closing down service lines because some of those service lines are heavily funded by Medicaid."
The One Big, Beautiful Bill Act continues to undergo negotiations in Congress.
