Why it matters: The “Big Beautiful Bill” includes significant changes to Medicaid funding that will particularly affect rural hospitals, which serve communities with higher percentages of Medicaid patients.
The big picture: While changes to Medicaid funding won’t take effect until 2028, rural healthcare facilities are already preparing for the transition.
By the numbers:
- According to the Kem C. Gardner Policy Institute, about 10% of Utah’s population is on Medicaid. Matt McCullough, Ph.D., Director of Rural Hospital Improvement at the Utah Hospital Association, says it’s one of the lowest rates in the nation.
- According to McCullough, Medicaid accounts for approximately 13% of hospital revenue in Utah
- Rural hospitals see a disproportionately higher percentage of Medicaid patients
Changes coming:
- Starting now: New work requirements and more frequent eligibility redeterminations (every six months instead of annually)
- In 2028: Changes to state-directed payments and provider assessment funding
Between the lines: More frequent eligibility reviews may lead to coverage gaps for vulnerable populations, especially those with language barriers or limited access to administrative support.
What they’re saying: “Rural hospitals are concerned because they have a higher percentage of population on Medicaid,” says McCullough.
The bottom line: The Utah Hospital Association is actively working with state officials to model the financial impact and help hospitals adapt to these coming changes while maintaining essential healthcare services in rural communities.