GUEST COLUMN: Medicaid cuts will be felt locally, with significant impact

Published 9:20 am Thursday, July 24, 2025

The nearly $1 trillion in cuts to the federal Medicaid program over the next nine years is likely to have significant impacts throughout Oregon but will be felt acutely in Jackson County, where 60,000 residents access health care coverage through the Oregon Health Plan, which is itself a recipient of Medicaid funds. According to the Oregon Health Authority, 23.3% are covered by Medicaid directly.

The key impact would be a loss of Medicaid coverage, with estimates ranging from 8.7 million to 11 million people nationally, and roughly between 100,000 and 200,000 statewide according to state analysts. The specific number in Jackson County is not yet available, but it’s likely all 60,000 recipients are likely to experience some impact whether it’s an increase in paperwork to meet the 80 hour per month rule that requires documentation of work, school, or volunteer hours or a loss of care entirely when hospitals close or skilled nursing facilities can no longer continue care. 

The measure will roll out gradually being felt more acutely after the midterm elections in 2026. However, those using the marketplace who receive subsidized healthcare through the Affordable Care Act, ACA, will see premiums rise more quickly at the end of 2025 when ACA subsidies expire. For instance, a person earning $25,000 could see their annual premium go from $160 per year to $1,077, according to the Kaiser Family Foundation study of HR1, the president’s “One Big Beautiful Bill”.

Hospitals and medical practices that receive Medicaid reimbursement will also feel the impact of HR1 and are planning now. For those of us living in more rural areas, this is likely to affect waiting times for surgeries and the availability to see a doctor in general, especially in hospital settings where diagnostics are performed. It’s unclear at this time what the cuts may do to emergency rooms or people in skilled nursing or memory care as they also take Medicaid patients, but it’s likely to be grim. 

Providence hospitals throughout Oregon, including Medford, face potential losses of more than $1 billion in reimbursements from Medicaid. At the same time, tariffs could drive up supply costs by tens of millions, according to Erik Wexler, their CEO.

When contacted for a comment regarding Providence Medford, spokesperson Jean P. Marks responded:

“The passage of H.R. 1 by Congress poses a significant threat to the health and well-being of our communities, placing essential health programs and services at risk while stripping access to health care for millions of Americans. Eliminating nearly $1 trillion from Medicaid and the ACA marketplace funding over the next decade will impact every patient. These sweeping reductions will limit health services, lead to care delays and longer wait times, especially in emergency departments, and place undue strain on overburdened healthcare systems.”

And Oregon’s hospitals were already struggling before the Medicaid cuts took place. 

According to the Hospital Association of Oregon, many hospitals posted losses on a day-to-day basis last year. Among those who made money providing care, the profit margin was less than 3%. 

So while many may feel that Medicaid’s program needed cuts to deal with “waste, fraud and abuse,” medical providers fear not being able to offer care to tens of thousands of Oregonians who are already at the intersection of extreme poverty and poor health, people for whom getting a job is not possible like those living in skilled nursing homes or those who have jobs with small employers who do not offer health insurance. 

What those who care for the extremely poor discover is that care delayed can quickly become care denied leading to either death or a preventable long term health crisis. One in six diabetic insulin users are known to ration doses now; when the cuts come down, will it be more? Seventy-four percent of Americans worried about their ability to pay for unexpected medical bills in April of this year, and I must ask, how many more worry about that today in the wake of the passage of H.R. 1? 

How many physicians are considering closing their offices or moving to larger communities with more private payers? How many hospitals will close? How far will rural residents have to drive for care?

These questions are not yet answerable, but they will be in the next two years. Will we as individuals and communities be ready to care for each other in the inevitable gap that will be made larger? 

The questions are obvious, the answers less so. Stay tuned.

Julie Akins is senior director of housing & community liaison for AllCare Health in Southern Oregon.