/ en Sat, 14 Jun 2025 12:57:40 -0500 Thu, 12 Jun 25 14:12:01 -0500 /news/headline/2025-06-12-threat-medicaid-cuts-rural-communities-highlighted-new-video <p>The latest video in the AHA’s series “Medicaid: Real Lives, Real Care” features Jennifer Clowers, regional chief financial officer of Our Lady of the Lake Health in Louisiana, explaining how Medicaid helps the system provide services such as school-based health clinics in rural communities, and why those communities could be impacted by potential Medicaid cuts from Congress. <a href="https://www.youtube.com/watch?v=4LclkrXxrAU">WATCH NOW</a> </p> Thu, 12 Jun 2025 14:12:01 -0500 Medicaid /news/headline/2025-06-10-video-highlights-medicaids-importance-preventative-care <p>The AHA June 10 released a new video in its series, “Medicaid: Real Lives, Real Care,” that features Missouri Hospital Association President and CEO Jon Doolittle sharing how important Medicaid is for preventative care and keeping people healthy. With Congress considering cuts to the program, Doolittle said potential Medicaid cuts could have ripple effects on the entire health care system that could reduce access to care for everyone. <a href="https://www.youtube.com/watch?v=ruC2QbZodNQ" target="_blank"><strong>WATCH NOW</strong></a></p> Tue, 10 Jun 2025 15:46:18 -0500 Medicaid /news/headline/2025-06-09-white-house-memo-directs-hhs-eliminate-waste-fraud-and-abuse-medicaid <p>The White House June 6 issued a <a href="https://www.whitehouse.gov/presidential-actions/2025/06/eliminating-waste-fraud-and-abuse-in-medicaid/" target="_blank">memorandum</a> directing the Secretary of the Department of Health and Human Services “to take appropriate action to eliminate waste, fraud, and abuse in Medicaid, including by ensuring Medicaid payments rates are not higher than Medicare, to the extent permitted by applicable law.” In the memo, the administration expresses its view that rapid growth in state directed payment programs is a threat to the nation’s long-term stability, and that the “imbalance between Medicaid and Medicare payment rates under these programs jeopardizes access to care for seniors.”  </p><p>The memo is in addition to the ongoing congressional reconciliation deliberations, which also include provisions impacting SDPs.</p> Mon, 09 Jun 2025 15:21:26 -0500 Medicaid <div class="container"><div class="row"><div class="col-md-8"><p>As we noted in our <a href="/advisory/2025-06-06-white-house-issues-presidential-memorandum-eliminating-waste-fraud-and-abuse-medicaid">June 6 Member Advisory</a>, the Administration is signaling it will make changes to State Directed Payment (SDP) programs used by managed care plans and how the payment rates for providers, including hospitals, are calculated. This change in regulatory policy could undermine legislative language in the reconciliation package passed by the House – H.R. 1, the One Big Beautiful Bill Act – on May 22. The Senate is currently reviewing H.R. 1, and draft text for the Senate Finance Committee, which has jurisdiction over taxes and Medicaid, could come as soon as this week. <strong>We understand there are efforts in the Senate to further restrict SDPs and provider taxes.</strong></p><p>The June 6 <a href="https://www.whitehouse.gov/presidential-actions/2025/06/eliminating-waste-fraud-and-abuse-in-medicaid/" target="_blank" title="The White House Presidential Actions: Eliminating Waste, Fraud, and Abuse in Medicaid">Presidential memorandum</a> outlines the Administration’s intent to ensure the Medicaid program does not pay providers through SDPs at rates which are higher than Medicare, though many states have in place payment levels that may exceed Medicare and are closer to average commercial rates (ACR). The House-passed reconciliation bill would allow for a grandfathering of existing rates, which reimburse providers above the Medicare payment level for Medicaid services, upon enactment of the legislation. It is important to note current law requires Medicaid payment for providers to be sufficient to ensure beneficiary access to services and SDPs are used to augment historically low Medicaid provider payments, including for critical community services such as maternal and behavioral health. Without supplemental payments, Medicaid fee-for-service payments in 2023 nationally paid 58 cents for every dollar that hospitals spent caring for Medicaid patients, and Medicaid managed care organizations paid 65 cents. In total, including supplemental payments, Medicaid paid hospitals $27.5 billion less than hospitals spent providing care to Medicaid beneficiaries.</p><p>The provider tax provisions in H.R. 1 disallow federal matching funds for state provider taxes that were increased (in amount or rate) after the date of enactment. This would significantly limit states’ ability to finance Medicaid using provider taxes, placing pressure on state budgets that would compound over time. Over time, the restrictions on this legitimate, vital funding tool will lead to diminished critical resources to support Medicaid beneficiaries. There are efforts in the Senate to further restrict the use of provider taxes, including by lowering the safe harbor threshold below 6% and fixing the annual revenue amount the tax currently raises into perpetuity.</p><p><span><strong>TAKE ACTION:</strong></span><strong> Please contact your senators and urge them to oppose any efforts to further weaken SDP and provider tax provisions as passed by the House. Changes under consideration by the Senate would deteriorate hospital Medicaid reimbursement rates and threaten access for all patients.</strong></p><h2>June 5 Action Alert, AHA Resources, and Upcoming Advocacy Day</h2><p>The AHA last week shared an Action Alert with new resources for hospital and health system leaders to use in conversations with their senators as they advocate for protecting Medicaid, the Affordable Care Act coverage gains, and access to health care and services in communities. <strong>Please see the </strong><a href="/action-alert/2025-06-05-act-now-ask-your-senators-protect-medicaid-and-access-care?utm_source=newsletter"><strong>June 5 Action Alert</strong></a><strong> for key messages and resources.</strong></p><p>In addition, if you haven’t registered yet, you can still make plans to join the AHA and hospital and health system leaders from across the country in Washington, D.C., June 17 for an AHA Advocacy Day. <a href="https://forms.office.com/pages/responsepage.aspx?id=QJMRube-Xk6EsjzBj3s2pnUzMzymJWtHjxrQd2BoFRpUNDNVUkdGWjYyRlJJTUNUVU8wWjVBNTRNWC4u&route=shorturl" target="_blank" title="AHA Advocacy Day Tuesday, June 17, 2025, Registration">Register today.</a></p><h2>Further Questions</h2><p>Visit the <a href="/advocacy/action-center">AHA Action Center</a> for more resources on these issues and other priorities important to hospitals and health systems. If you have further questions, please contact the AHA at 800-424-4301.</p></div><div class="col-md-4"><a href="/system/files/media/file/2025/06/ACT-NOW-Ask-Your-Senators-to-Protect-Medicaid-Payment-Rates-in-Reconciliation-Package.pdf"><img src="/sites/default/files/inline-images/ACT-NOW-Ask-Your-Senators-to-Protect-Medicaid-Payment-Rates-in-Reconciliation-Package-Page-1.png" data-entity-uuid="18ef82be-e2cf-4d13-b324-531a670bd428" data-entity-type="file" alt="Action Alert: ACT NOW: Ask Your Senators to Protect Medicaid Payment Rates in Reconciliation Package." width="695" height="900"></a></div></div></div> Sun, 08 Jun 2025 18:00:41 -0500 Medicaid <div class="container"><div class="row"><div class="col-md-8"><p>The White House June 6 issued a <a href="https://www.whitehouse.gov/presidential-actions/2025/06/eliminating-waste-fraud-and-abuse-in-medicaid/" target="_blank" title="The White House Presidential Actions: Eliminating Waste, Fraud, and Abuse in Medicaid">Presidential memorandum</a> that directs the Secretary of the Department of Health and Human Services “to take appropriate action to eliminate waste, fraud, and abuse in Medicaid, including by ensuring Medicaid payments rates are not higher than Medicare, to the extent permitted by applicable law.” In the memorandum, the Administration expresses its view that rapid growth in State Directed Payment (SDP) programs is a threat to the nation’s long-term stability, and that the “imbalance between Medicaid and Medicare payment rates under these programs jeopardizes access to care for seniors.”</p><p>This memorandum is in addition to the ongoing congressional reconciliation deliberations, which also include provisions impacting SDPs. AHA will provide additional updates to inform members of the impact of this action relative to congressional actions and next steps.</p><h2>Background on SDPs</h2><p>Many states use SDPs to ensure that Medicaid beneficiaries can access health care by mitigating low provider payment rates. Hospitals use these payments to maintain essential services, including labor and delivery, behavioral health, and cancer treatment. Without supplemental payments, Medicaid fee-for-service payments in 2023 nationally paid 58 cents for every dollar that hospitals spent caring for Medicaid patients, and Medicaid managed care organizations paid 65 cents. In total, including supplemental payments, Medicaid paid hospitals $27.5 billion less than hospitals spent providing care to Medicaid beneficiaries.</p><h2>Further Questions</h2><p>If you have further questions, please contact the AHA at 800-424-4301.</p></div><div class="col-md-4"><a href="/system/files/media/file/2025/06/Member-Advisory-White-House-Issues-Presidential-Memorandum-on%20-Eliminating-Waste-Fraud-and-Abuse-in-Medicaid.pdf"><img src="/sites/default/files/inline-images/Member-Advisory-White-House-Issues-Presidential-Memorandum-on%20-Eliminating-Waste-Fraud-and-Abuse-in-Medicaid.png" data-entity-uuid="50e7e42a-40a4-4d4c-aa6e-2d30b3269f45" data-entity-type="file" alt="Member Advisory: White House Issues Presidential Memorandum on ‘Eliminating Waste, Fraud and Abuse in Medicaid’ page 1." width="695" height="900"></a></div></div></div> Fri, 06 Jun 2025 21:16:33 -0500 Medicaid <div class="container"><div class="row"><div class="col-md-8"><p>As the next step in the budget reconciliation process, the Senate is taking up the House-passed version of the budget reconciliation bill. Senate key committees, Senate leaders and others are considering changes to the House version. Within the House-passed legislation are <a href="/advisory/2025-05-22-aha-summary-one-big-beautiful-bill-acts-provisions-impacting-hospitals-and-health-systems">proposals</a> that could lead to more than 10.9 million people losing Medicaid coverage, according to the <a href="https://nam11.safelinks.protection.outlook.com/?url=https%3A%2F%2Femail.advocacy.aha.org%2FNzEwLVpMTC02NTEAAAGa4Ppq2GW5NgYfGhwWcTHupAVgY9HktOSAqCQdmwUtVnHjbrKjo7IccvAT_4oYd8eqGpD9b9k%3D&data=05%7C02%7Cbmirza%40aha.org%7C4682eb8b25c5407c3d5d08dda4785e2a%7Cb9119340beb74e5e84b23cc18f7b36a6%7C0%7C0%7C638847559092782088%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=j%2BcYXOOXUihHMg0tPXhM8ZNSld5ujFX2wBiiVpbyH6Q%3D&reserved=0">Congressional Budget Office</a>.</p><p>Draft text for some committees is coming out this week, and draft text for the Senate Finance Committee, which has jurisdiction over taxes and Medicaid, could come as soon as next week. The chamber aims to have the bill ready for a vote on the Senate floor before the July 4 holiday.</p><p><strong>Don’t wait! As Senate committees draft legislative text this week, </strong><a href="/2020-10-07-get-involved"><strong>ask your senators</strong></a><strong> to protect Medicaid, the Affordable Care Act coverage gains and access to health care and services in your community.</strong> Share with your senators the impact of these proposals on your hospital’s ability to care for patients. It is critical that senators understand that the considerable changes to Medicaid cannot be implemented by the date of enactment, and additional time would be necessary for any financing or provider payment changes. It is also important that the Senate does not make additional harmful changes to provider tax rates and state-directed payments.</p><p><strong>Please urge your senators </strong><em><strong>to reject </strong></em><strong>detrimental policy changes that could reduce access to health care for millions of Americans — including their constituents.</strong> Other proposals under consideration would reduce consumers’ access to the Health Insurance Marketplace and put other care sites at risk, particularly in rural and medically underserved areas.</p><h2 class="text-align-center"><a href="/2020-10-07-get-involved"><span><strong>TAKE ACTION NOW</strong></span></a></h2><h3>Medicaid Resources</h3><p><strong>Explain that Medicaid is vital to your communities.</strong> Use the following AHA resources in your advocacy efforts and watch for new resources to be published soon.</p><ul><li><strong>NEW: Fact Sheets and Infographics.</strong> The AHA has developed a series of fact sheets and infographics to inform your advocacy efforts. These include <a href="/fact-sheets/2025-06-05-medicaid-spending-reductions-would-lead-losses-jobs-economic-activity-and-tax-revenue-states">a <strong>new resource showing statewide impacts</strong></a> of each $1 billion incremental reduction in Medicaid spending and how it would lead to job losses, lost economic activity and losses in state, federal and local tax revenue. In addition, see a <a href="/fact-sheets/2025-06-05-medicaid-coverage-supports-rural-patients-hospitals-and-communities"><strong>new fact sheet on how Medicaid supports rural</strong></a> patients, hospitals and communities. Visit the <a href="/advocacy/advocacy-issues/medicaid">Medicaid Advocacy Issue</a> page for more fact sheets and resources.</li><li><strong>June 17 AHA Advocacy Day.</strong> Join the AHA in Washington, D.C., to tell congressional leaders how these policy changes will affect your hospitals. <a href="https://forms.office.com/pages/responsepage.aspx?id=QJMRube-Xk6EsjzBj3s2pnUzMzymJWtHjxrQd2BoFRpUNDNVUkdGWjYyRlJJTUNUVU8wWjVBNTRNWC4u&route=shorturl">Register today</a>.</li><li><strong>Digital Toolkit.</strong> Use this toolkit to engage stakeholders, such as your hospital or health system teams and community leaders, in joining the fight to protect Medicaid. The <a href="/advocacy/advocacy-issues/medicaid">toolkit</a> includes a Medicaid Made Simple video, infographics and fact sheets detailing state impacts, and sample social media posts, stakeholder messages and newsletter copy.</li><li><strong>Coalition to Strengthen America’s Health Care Resources.</strong> The <a href="https://strengthenhealthcare.org/new-coalition-ad-mom-highlights-impact-of-medicaid-cuts-on-americas-seniors" target="_blank">Coalition to Strengthen America’s Healthcare</a>, of which the AHA is a founding member, has a number of digital resources and tools that can assist your advocacy efforts.</li></ul><h3>Health Insurance Marketplace</h3><p><strong>Explain why Congress should reject changes to the Affordable Care Act and </strong><a href="/fact-sheets/2025-02-07-fact-sheet-enhanced-premium-tax-credits"><strong>extend the enhanced premium tax credits</strong></a> before they expire at the end of the year, as they have increased access to health care coverage and high-quality care for patients and communities served by hospitals, health systems and other providers.</p><ul><li><strong>NEW: Fact Sheet.</strong> The AHA has developed a new resource showing how <a href="/fact-sheets/2025-06-05-fact-sheet-one-big-beautiful-bill-act-would-significantly-reduce-availability-coverage-health-insurance"><strong>proposed changes to the Affordable Care Act marketplaces</strong></a><strong> </strong>would lead to millions of people losing their coverage.</li></ul><h3>Site-Neutral Payment Policies</h3><p><strong>Tell your lawmakers why they should </strong><a href="/advocacy/advocacy-issues/2023-09-11-advocacy-issue-site-neutral-payment-proposals"><strong>reject site-neutral policies</strong></a>, as they would reduce patient access to vital health care services, particularly in rural and other medically underserved communities.</p><h3>340B Drug Pricing Program</h3><p><strong>Ask your lawmakers to </strong><a href="/340b-drug-savings-program"><strong>preserve the 340B program</strong></a> and ensure the program continues to help eligible hospitals stretch limited resources and provide more comprehensive services to more patients.</p><h2>Further Questions</h2><p>Visit the <a href="/advocacy/action-center">AHA Action Center</a> for more resources on these issues and other priorities important to hospitals and health systems. If you have further questions, please contact the AHA at 800-424-4301.</p></div><div class="col-md-4"><p><a href="/system/files/media/file/2025/06/act-now-ask-your-senators-to-protect-medicaid-and-access-to-care-alert-6-5-2025.pdf" target="_blank" title="Click here to download the Action Alert Act Now: Ask Your Senators to Protect Medicaid and Access to Care PDF."><img src="/sites/default/files/2025-06/cover-act-now-ask-your-senators-to-protect-medicaid-and-access-to-care-alert-6-5-2025.png" data-entity-uuid data-entity-type="file" alt="Cover Act Now: Ask Your Senators to Protect Medicaid and Access to Care PDF" width="NaN" height="NaN"></a></p></div></div></div> Thu, 05 Jun 2025 16:34:06 -0500 Medicaid /fact-sheets/2025-06-05-medicaid-spending-reductions-would-lead-losses-jobs-economic-activity-and-tax-revenue-states <div class="container"><div class="row"><div class="col-md-8"><p>Medicaid is the nation’s largest single source of coverage, providing access to care for 72 million Americans. It primarily serves low-income populations — children and their families, adults, seniors and disabled individuals. Almost half of adults in poverty, nearly 4 in 10 children, and over 60% of nursing home residents are covered by Medicaid. And, for over 12 million dually eligible Medicare-Medicaid enrollees, Medicaid helps with premiums and cost sharing, as well as provides long-term care services. The program provides a broad array of health care services, such as primary and acute care services, as well as long-term services and supports.</p><p>Congress is considering a set of proposed Medicaid cuts that threaten coverage for the millions of Americans who rely on the program and threaten access to health care for all communities. However, there is still significant uncertainty regarding the type, scale and timing of these cuts. As such, the AHA has modeled the statewide economic impacts of each $1 billion incremental reduction in Medicaid spending. These incremental impacts can then be scaled to various spending reduction scenarios to estimate how those cuts may be experienced at the state-level.</p><p>The AHA’s analysis reflects the incremental economic impacts of Medicaid cuts across the entire program in each state, including spending on hospitals, physician offices, specialists and pharmacies. The share of the $1 billion reduction experienced by each sector is based on AHA estimates of that sector’s share of Medicaid spending using data from the Medicaid and CHIP Payment and Access Commission (MACPAC). The AHA then uses economic impact modeling from Lightcast, a labor market analytics company, to estimate how those spending cuts would affect jobs and economic activity by state.</p><p>For every $1 billion reduction in Medicaid spending over 10 years, we estimate:</p><ul><li>The annual average of hospital jobs lost.</li><li>The annual average of total jobs lost across the entire state economy.</li><li>The total 10-year estimated reduction in statewide economic activity.</li><li>The total 10-year estimated loss of federal, state and local tax revenue as a result of the reduction in statewide economic activity.</li></ul><p>These estimates show the broad economic and community impact of Medicaid, beyond just health care coverage and benefits. Medicaid cuts would destabilize communities, harming the economic security and health of the millions of people who keep our economy running strong.</p><h2>Economic Impacts of Each $1B Reduction in Medicaid Spending<a href="#note1">*</a></h2><table><thead><tr><th>State</th><th>Annual Average Hospital Jobs Lost</th><th>Annual Average Total Jobs Lost</th><th>10-Year Reduction in Statewide Economic Activity</th><th>10-Year Loss of Federal, State and Local Tax Revenue</th></tr></thead><tbody><tr><td>Alabama</td><td>1,790</td><td>16,101</td><td>$1.7B</td><td>$41.8M</td></tr><tr><td>Alaska</td><td>1,271</td><td>12,600</td><td>$1.6B</td><td>$41.5M</td></tr><tr><td>Arizona</td><td>1,447</td><td>15,832</td><td>$2.1B</td><td>$61.4M</td></tr><tr><td>Arkansas</td><td>1,756</td><td>15,315</td><td>$1.6B</td><td>$43.8M</td></tr><tr><td>California</td><td>1,122</td><td>14,956</td><td>$2.3B</td><td>$83.1M</td></tr><tr><td>Colorado</td><td>1,396</td><td>14,887</td><td>$2.1B</td><td>$53.7M</td></tr><tr><td>Connecticut</td><td>1,363</td><td>12,353</td><td>$1.8B</td><td>$54.7M</td></tr><tr><td>Delaware</td><td>1,129</td><td>12,178</td><td>$1.6B</td><td>$39.4M</td></tr><tr><td>District of Columbia</td><td>1,143</td><td>8,672</td><td>$1.3B</td><td>$33.8M</td></tr><tr><td>Florida</td><td>1,621</td><td>17,512</td><td>$2.3B</td><td>$74.7M</td></tr><tr><td>Georgia</td><td>1,551</td><td>16,657</td><td>$2.0B</td><td>$52.3M</td></tr><tr><td>Hawaii</td><td>1,316</td><td>14,354</td><td>$1.8B</td><td>$70.1M</td></tr><tr><td>Idaho</td><td>1,404</td><td>15,467</td><td>$1.7B</td><td>$40.9M</td></tr><tr><td>Illinois</td><td>1,455</td><td>15,307</td><td>$2.0B</td><td>$71.6M</td></tr><tr><td>Indiana</td><td>1,573</td><td>14,191</td><td>$1.7B</td><td>$40.8M</td></tr><tr><td>Iowa</td><td>1,584</td><td>14,321</td><td>$1.6B</td><td>$41.0M</td></tr><tr><td>Kansas</td><td>1,640</td><td>15,071</td><td>$1.7B</td><td>$43.5M</td></tr><tr><td>Kentucky</td><td>1,678</td><td>13,964</td><td>$1.6B</td><td>$38.7M</td></tr><tr><td>Louisiana</td><td>1,595</td><td>16,767</td><td>$1.7B</td><td>$50.7M</td></tr><tr><td>Maine</td><td>1,439</td><td>13,403</td><td>$1.7B</td><td>$62.0M</td></tr><tr><td>Maryland</td><td>1,444</td><td>13,074</td><td>$1.7B</td><td>$55.4M</td></tr><tr><td>Massachusetts</td><td>1,302</td><td>12,816</td><td>$1.9B</td><td>$50.5M</td></tr><tr><td>Michigan</td><td>1,571</td><td>15,865</td><td>$1.9B</td><td>$53.6M</td></tr><tr><td>Minnesota</td><td>1,455</td><td>14,733</td><td>$2.0B</td><td>$56.9M</td></tr><tr><td>Mississippi</td><td>1,715</td><td>15,970</td><td>$1.5B</td><td>$44.9M</td></tr><tr><td>Missouri</td><td>1,490</td><td>15,088</td><td>$1.8B</td><td>$43.2M</td></tr><tr><td>Montana</td><td>1,580</td><td>14,837</td><td>$1.7B</td><td>$33.4M</td></tr><tr><td>Nebraska</td><td>1,537</td><td>13,966</td><td>$1.7B</td><td>$46.5M</td></tr><tr><td>Nevada</td><td>1,371</td><td>14,717</td><td>$1.8B</td><td>$52.6M</td></tr><tr><td>New Hampshire</td><td>1,528</td><td>12,344</td><td>$1.7B</td><td>$43.0M</td></tr><tr><td>New Jersey</td><td>1,367</td><td>12,946</td><td>$1.8B</td><td>$68.7M</td></tr><tr><td>New Mexico</td><td>1,380</td><td>14,632</td><td>$1.6B</td><td>$56.9M</td></tr><tr><td>New York</td><td>1,159</td><td>12,131</td><td>$1.9B</td><td>$67.6M</td></tr><tr><td>North Carolina</td><td>1,544</td><td>15,994</td><td>$1.9B</td><td>$50.3M</td></tr><tr><td>North Dakota</td><td>1,555</td><td>13,250</td><td>$1.5B</td><td>$38.3M</td></tr><tr><td>Ohio</td><td>1,564</td><td>15,167</td><td>$1.9B</td><td>$55.7M</td></tr><tr><td>Oklahoma</td><td>1,600</td><td>16,216</td><td>$1.7B</td><td>$37.7M</td></tr><tr><td>Oregon</td><td>1,259</td><td>13,892</td><td>$1.8B</td><td>$49.4M</td></tr><tr><td>Pennsylvania</td><td>1,562</td><td>13,352</td><td>$1.8B</td><td>$53.6M</td></tr><tr><td>Rhode Island</td><td>1,587</td><td>13,101</td><td>$1.7B</td><td>$58.9M</td></tr><tr><td>South Carolina</td><td>1,551</td><td>15,757</td><td>$1.7B</td><td>$52.0M</td></tr><tr><td>uth Dakota</td><td>1,531</td><td>13,167</td><td>$1.6B</td><td>$39.2M</td></tr><tr><td>Tennessee</td><td>1,463</td><td>14,486</td><td>$1.8B</td><td>$51.3M</td></tr><tr><td>Texas</td><td>1,506</td><td>18,178</td><td>$2.2B</td><td>$60.3M</td></tr><tr><td>Utah</td><td>1,487</td><td>15,838</td><td>$1.9B</td><td>$49.3M</td></tr><tr><td>Vermont</td><td>1,498</td><td>13,125</td><td>$1.6B</td><td>$56.1M</td></tr><tr><td>Virginia</td><td>1,410</td><td>13,732</td><td>$1.7B</td><td>$52.5M</td></tr><tr><td>Washington</td><td>1,153</td><td>12,659</td><td>$1.9B</td><td>$77.1M</td></tr><tr><td>West Virginia</td><td>1,525</td><td>13,602</td><td>$1.4B</td><td>$31.4M</td></tr><tr><td>Wisconsin</td><td>1,615</td><td>15,026</td><td>$1.8B</td><td>$50.1M</td></tr><tr><td>Wyoming</td><td>1,462</td><td>13,772</td><td>$1.4B</td><td>$33.5M</td></tr></tbody></table><p><span><strong>Sources:</strong></span> Economic impact modeling conducted by AHA using Lightcast (lightcast.io), as of May 2025, Total Medicaid Benefit Spending by State and Category from MACPAC, and sector employment levels from the North American Industry Classification System (NAICS).</p><p id="note1">* This analysis reflects the incremental economic impacts of each $1B reduction in Medicaid spending across all industries. The share of the $1B reduction experienced by each sector is based on AHA estimates of that sector’s share of Medicaid spending using data from MACPAC. These incremental impacts can be applied to Medicaid spending reductions across the 2026-2035 period. Total jobs lost are a result of the reduction in statewide economic activity; for example, this would include jobs lost because of less hospital spending and higher hospital unemployment resulting in lower economic activity such as buying goods and services. The loss of tax revenue includes reductions in state and local general sales and property taxes.</p></div><div class="col-md-4"><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2025/06/Medicaid-Spending-Reductions-Would-Lead-to-Losses-in-Jobs-Economic-Activity-and-Tax-Revenue-for-States.pdf" target="_blank" title="Click here to download the Medicaid Spending Reductions Would Lead to Losses in Jobs, Economic Activity and Tax Revenue for States PDF.">Download the Fact Sheet PDF</a></div><p><a href="/system/files/media/file/2025/06/Medicaid-Spending-Reductions-Would-Lead-to-Losses-in-Jobs-Economic-Activity-and-Tax-Revenue-for-States.pdf" target="_blank" title="Click here to download the Medicaid Spending Reductions Would Lead to Losses in Jobs, Economic Activity and Tax Revenue for States PDF."><img src="/sites/default/files/inline-images/Page-1-Medicaid-Spending-Reductions-Would-Lead-to-Losses-in-Jobs-Economic-Activity-and-Tax-Revenue-for-States.png" data-entity-uuid="4a19bc11-55f8-4e12-ae1d-f41a5f4bef79" data-entity-type="file" alt="Medicaid Spending Reductions Would Lead to Losses in Jobs, Economic Activity and Tax Revenue for States page 1." width="695" height="900"></a></p></div></div></div> table, th, td { border: 1px solid #002855; } table { margin-top: 20px; margin-bottom: 20px; } th { background-color: #002855; color: #ffffff; Thu, 05 Jun 2025 06:00:00 -0500 Medicaid /fact-sheets/2025-06-05-medicaid-coverage-supports-rural-patients-hospitals-and-communities <div class="container"><div class="row"><div class="col-md-8"><p><img src="/sites/default/files/inline-images/16-1-Million-People-in-Rural-Communities-Rely-on-Medicaid.png" data-entity-uuid="5bd93908-0c93-4c85-8af2-4b1d10bc33fb" data-entity-type="file" alt="16.1 Million People in Rural Communities Rely on Medicaid" width="299" height="267" class="align-right">One in seven Americans live in rural areas and rely on rural hospitals and health systems for the health and well-being of their communities.<a href="#fn1"><sup>1</sup></a> The importance of rural hospitals cannot be overstated, as individuals who live in these communities face greater challenges in accessing health care due to a number of factors, including a lack of affordable coverage options, geographic isolation and a shortage of health care providers.<a href="#fn2"><sup>2</sup></a> Medicaid, which covers 16.1 million people in rural communities, plays a vital role in addressing these barriers and sustaining rural hospitals so they can continue to support patients and their communities.<a href="#fn3"><sup>3</sup></a> As part of a larger budget process, many in Congress are currently considering cuts to the Medicaid program, which could have a devastating impact on rural hospitals and patients.</p><h2>Impact of Proposed Medicaid Cuts on Rural Communities</h2><p>Medicaid generally pays hospitals far less than the costs of caring for Medicaid patients. The difference between Medicaid payments and costs incurred by hospitals to provide care, known as the “Medicaid shortfall,” was $27.5 billion in 2023.<a href="#fn4"><sup>4</sup></a> Congress is considering policy options that could collectively reduce federal spending for the Medicaid program by hundreds of billions of dollars over the next 10 years, which would undermine the ability of hospitals, in particular rural hospitals, to continue to serve their patients.</p><p><img src="/sites/default/files/inline-images/Proposed-Cuts-Could-Mean.png" data-entity-uuid="9fe59eda-0e35-4ed2-ac8a-2ce61c8ab427" data-entity-type="file" alt="Proposed Cuts Could Mean: Coverage Losses; Fewer Health Care Services; Fewer Jobs; More Hospital Financial Instability." width="284" height="140" class="align-right">Among the targets for cuts being considered by Congress are supplemental payments, which are used to mitigate historically low Medicaid payment rates for services. These funding sources are critical, as many states have been able to target support to rural hospitals through supplemental payments and lessen the gap between Medicaid base payments and the cost of providing care. If the proposed cuts are enacted, the effects will ripple across rural communities and could result in coverage losses, fewer available health care services, fewer jobs and greater hospital financial instability.</p><h2>The Importance of Rural Hospitals</h2><p><img src="/sites/default/files/inline-images/About-half-of-rural-hospitals-consistently-experienced-negative-operating-margins.png" data-entity-uuid="12f19b20-8b38-4a5f-929a-f6117d5e4ea8" data-entity-type="file" alt="About half of rural hospitals consistently experienced negative operating margins from patient services from 2017-2022." width="238" height="205" class="align-right">Rural hospitals serve as critical – and sometimes the sole – source of care for rural communities. Consequently, rural hospitals face elevated levels of uncompensated care that can be linked to higher uninsured rates in rural communities.<a href="#fn5"><sup>5</sup></a> Due to this and other fiscal pressures, many rural hospitals operate under tight margins and face a disproportionate threat of closure.<a href="#fn6"><sup>6</sup></a> About half of rural hospitals consistently experienced negative operating margins from patient services from 2017-2022.<a href="#fn7"><sup>7</sup></a> Some hospitals have dealt with negative margins by reducing costs, which can include eliminating service lines or closing altogether. According to the UNC Cecil G. Sheps Center, over 100 rural hospitals have closed or converted in the last decade.<a href="#fn8"><sup>8</sup></a></p><p>Hospital closures and service line reductions can be devastating to rural communities. Behavioral health and obstetrics care are two examples where despite a significant need for this care in rural areas, providers and services continue to be limited or entirely unavailable in rural communities due to fiscal and other issues.<a href="#fn9"><sup>9</sup></a><sup>,</sup><a href="#fn10>10</a>,<a href="><sup>11</sup></a> When providers or essential services are not available locally, patients are required to travel long distances or, worse, forego care altogether, leading to health complications and unnecessary hospitalizations.</p><h2>Medicaid’s Role as a Lifeline for Rural Patients, Communities and Hospitals</h2><p>There are three primary ways in which Medicaid supports rural communities and hospitals:</p><h3><img src="/sites/default/files/inline-images/Percentage-of-Rural-Births-Covered-by-Medicaid-2023.png" data-entity-uuid="8fc3d416-2e58-44dd-9f69-7787485f3bc8" data-entity-type="file" alt="Percentage of Rural Births Covered by Medicaid, 2023, by state. Source: Natality data on the CDC WONDER Online Database. Created with Datawrapper." width="404" height="321" class="align-right">1. Medicaid is a critical coverage option for people who live in rural areas.</h3><p>Medicaid is a significant source of coverage for individuals and families in rural areas who would otherwise not be able to afford insurance. In nearly all states, Medicaid covers a larger share of both adults and children in rural communities than urban communities.<a href="#fn12"><sup>12</sup></a> Nearly 50% of children and 18% of adults in rural communities are covered by Medicaid.<a href="#fn13"><sup>13</sup></a> And nearly 50% of babies born in rural areas are covered by Medicaid.<a href="#fn14"><sup>14</sup></a></p><h3>2. Medicaid improves access to care in rural areas.</h3><p>Medicaid is a powerful tool in enabling people to overcome barriers to care. Children with Medicaid coverage are four times more likely to have regular sources of care and two to three times more likely to receive preventive care services than uninsured children.<a href="#fn15"><sup>15</sup></a> Adult Medicaid enrollees are five times more likely to have regular sources of care and four times more likely to receive preventive care services than individuals without coverage. With more patients covered, providers are more likely to be able to sustain themselves financially and, in some cases, expand the services they can offer in rural areas.</p><h3>3. Medicaid stabilizes and strengthens rural hospitals and workers.</h3><p>Medicaid plays a significant role in reducing uncompensated care and stabilizing hospitals in rural communities. Higher rates of Medicaid coverage for adults have been associated with improved hospital financial performance and lower likelihood of closure, especially in rural areas that have expanded Medicaid. The majority (74%) of rural hospital closures happened in states where Medicaid expansion was not in place or had been in place for less than a year.<a href="#fn16"><sup>16</sup></a></p><p>Medicaid coverage directly affects the demand for services in rural areas, and therefore the need for a robust health care workforce. Several studies on the impacts of Medicaid on the primary care and behavioral health workforce showed that states that have expanded Medicaid may be able to recruit, or may attract, additional providers due to the higher demand for services.<a href="#fn17"><sup>17</sup></a></p><p>And Medicaid’s contribution to the workforce is not limited to health care providers — rural hospitals typically serve as one of the largest employers in their communities and economic foundations of their local economy. This allows Medicaid to support more economically stable and vibrant communities.</p><hr><h2>End Notes</h2><ol><li id="fn1"><a href="https://aspe.hhs.gov/sites/default/files/documents/6056484066506a8d4ba3dcd8d9322490/rural-health-rr-30-Oct-24.pdf">aspe.hhs.gov/sites/default/files/documents/6056484066506a8d4ba3dcd8d9322490/rural-health-rr-30-Oct-24.pdf</a></li><li id="fn2"><a href="https://www.gao.gov/blog/why-health-care-harder-access-rural-america" target="_blank">gao.gov/blog/why-health-care-harder-access-rural-america</a></li><li id="fn3"><a href="https://www.kff.org/other/state-indicator/medicaid-enrollees-by-urban-rural-status/?dataView=1&currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D" target="_blank">kff.org/other/state-indicator/medicaid-enrollees-by-urban-rural-status/?dataView=1¤tTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D</a></li><li id="fn4"><a href="/system/files/media/file/2025/02/Fact-Sheet-Medicaid-20250204.pdf" target="_blank">aha.org/system/files/media/file/2025/02/Fact-Sheet-Medicaid-20250204.pdf</a></li><li id="fn5"><a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10924546/#:~:text=Rural%20hospitals%20have%20more%20uncompensated,change%20in%20non%2Dexpansion%20states" target="_blank">mc.ncbi.nlm.nih.gov/articles/PMC10924546/#:~:text=Rural%20hospitals%20have%20more%20uncompensated,change%20in%20non%2Dexpansion%20states</a></li><li id="fn6"><a href="https://www.kff.org/health-costs/issue-brief/hospital-margins-rebounded-in-2023-but-rural-hospitals-and-those-with-high-medicaid-shares-were-struggling-more-than-others/#:~:text=About%20half%20of%20low%2Dvolume,designation%20had%20negative%20operating%20margins" target="_blank">kff.org/health-costs/issue-brief/hospital-margins-rebounded-in-2023-but-rural-hospitals-and-those-with-high-medicaid-shares-werestruggling-more-than-others/#:~:text=About%20half%20of%20low%2Dvolume,designation%20had%20negative%20operating%20margins</a></li><li id="fn7"><a href="/system/files/media/file/2024/04/Assessing-the-Impact-of-COVID-19-on-Rural-Hospitals-report.pdf" target="_blank">aha.org/system/files/media/file/2024/04/Assessing-the-Impact-of-COVID-19-on-Rural-Hospitals-report.pdf</a></li><li id="fn8"><a href="https://www.shepscenter.unc.edu/programs-projects/rural-health/rural-hospital-closures/" target="_blank">shepscenter.unc.edu/programs-projects/rural-health/rural-hospital-closures/</a>; converted facilities no longer offer inpatient services but continue to provide some health care services.</li><li id="fn9"><a href="https://familymedicine.uw.edu/rhrc/publications/changes-in-the-supply-and-rural-urban-distribution-of-selected-behavioral-health-providers/" target="_blank">familymedicine.uw.edu/rhrc/publications/changes-in-the-supply-and-rural-urban-distribution-of-selected-behavioral-health-providers/</a></li><li id="fn10"><a href="https://www.gao.gov/products/gao-23-105515" target="_blank">gao.gov/products/gao-23-105515</a></li><li id="fn11"><a href="https://www.gao.gov/blog/additional-risks-and-challenges-pregnant-women-rural-and-underserved-communities" target="_blank">gao.gov/blog/additional-risks-and-challenges-pregnant-women-rural-and-underserved-communities</a></li><li id="fn12"><a href="https://www.kff.org/medicaid/issue-brief/the-role-of-medicaid-in-rural-america/" target="_blank">kff.org/medicaid/issue-brief/the-role-of-medicaid-in-rural-america/</a></li><li id="fn13"><a href="https://ccf.georgetown.edu/2023/08/17/medicaids-coverage-role-in-small-towns-and-rural-areas/" target="_blank">ccf.georgetown.edu/2023/08/17/medicaids-coverage-role-in-small-towns-and-rural-areas/</a></li><li id="fn14"><a href="/system/files/media/file/2025/02/Fact-Sheet-Medicaid-20250204.pdf" target="_blank">aha.org/system/files/media/file/2025/02/Fact-Sheet-Medicaid-20250204.pdf</a></li><li id="fn15"><a href="https://www.ahip.org/resources/the-value-of-medicaid-providing-access-to-care-and-preventive-health-services" target="_blank">ahip.org/resources/the-value-of-medicaid-providing-access-to-care-and-preventive-health-services</a></li><li id="fn16"><a href="/system/files/media/file/2022/09/rural-hospital-closures-threaten-access-report.pdf" target="_blank">aha.org/system/files/media/file/2022/09/rural-hospital-closures-threaten-access-report.pdf</a></li><li id="fn17"><a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9262825/" target="_blank">EFFECTS OF THE ACA MEDICAID EXPANSION ON THE COMPENSATION OF NEW PRIMARY CARE PHYSICIANS - PMC</a></li></ol></div><div class="col-md-4"><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2025/06/Medicaid-Coverage-Supports-Rural-Patients-Hospitals-and-Communities.pdf" target="_blank" title="Click here to download the Medicaid Coverage Supports Rural Patients, Hospitals, and Communities fact sheet PDF.">Download the Fact Sheet PDF</a></div><a href="/system/files/media/file/2025/06/Medicaid-Coverage-Supports-Rural-Patients-Hospitals-and-Communities.pdf" target="_blank" title="Click here to download the Medicaid Coverage Supports Rural Patients, Hospitals, and Communities fact sheet PDF."><img src="/sites/default/files/inline-images/Page-1-Medicaid-Coverage-Supports-Rural-Patients-Hospitals-and-Communities-20250605.png" data-entity-uuid="60c6085a-1780-4fb4-8f27-76caf6eddc36" data-entity-type="file" alt="Medicaid Coverage Supports Rural Patients, Hospitals, and Communities fact sheet page 1." width="693" height="900"></a></div></div></div> h2 { color: #9d2235; } h3 { color: #003087; } Thu, 05 Jun 2025 06:00:00 -0500 Medicaid /news/headline/2025-06-04-cbo-report-finds-nearly-11-million-could-become-uninsured-if-reconciliation-bill-enacted <p>A Congressional Budget Office <a href="https://www.cbo.gov/publication/61461" target="_blank">report</a> released June 4 found that enactment of the fiscal year 2025 budget reconciliation bill, the <a href="https://www.congress.gov/bill/119th-congress/house-bill/1" target="_blank">One Big Beautiful Bill Act</a> (H.R. 1), would lead to 10.9 million people becoming uninsured in 2034 due to significant changes to the Medicaid program and Affordable Care Act coverage. A follow-up letter from the <a href="https://www.cbo.gov/system/files/2025-06/Wyden-Pallone-Neal_Letter_6-4-25.pdf" target="_blank">CBO</a> provides more detail on how these changes would impact the number of uninsured. The CBO also estimated that the bill would lower gross benchmark premiums for marketplace plans under the ACA by an average of 12.2%.</p> Wed, 04 Jun 2025 14:57:52 -0500 Medicaid /news/headline/2025-06-03-new-aha-video-series-highlights-value-medicaid-and-need-protect-access-care <p>The AHA June 3 launched the first in a new video series, “Medicaid: Real Lives, Real Care,” highlighting the importance of Medicaid and why proposed cuts to the program would jeopardize access to care for patients and communities across America. </p><p>If congressional proposals go into effect, hospitals — especially in rural and underserved areas — will be forced to make difficult decisions about whether they will have to reduce services, staff and potentially consider closing their doors. </p><p>In this video, Ruby Kirby, R.N., CEO of Bolivar General Hospital and Camden General Hospital in Tennessee, explains why rural Americans need Medicaid and why Congress must protect it. <a href="https://www.youtube.com/watch?v=uoYscolvMfw" target="_blank"><strong>WATCH NOW</strong></a> </p> Tue, 03 Jun 2025 16:56:40 -0500 Medicaid