KANSAS CITY, Mo. — Earlier this week, we told you about Medicaid cuts in President Trump's self-proclaimed "Big, Beautiful Bill." Because it’s such a complex issue, we’re continuing to break it down.
I spoke to an economist who explained how these cuts could hurt providers that accept Medicaid. And to better illustrate what he shared, we stopped by a local ice cream shop to offer an analogy to highlight the potential impacts.
THE ICE CREAM ANALOGY:
The spot we visited was Foggi Ice Cream in Mission, Kan., where they use nitrogen to freeze their ice cream.
One economist explains that Medicaid cuts could put plans for providers who rely on Medicaid dollars on ice.
"So, people who are providing Medicaid are going to look at these new rules and say, 'You know, I have a business to run and if I’m not going to get paid or I’m not going to get paid commensurate to the work I’m putting in, I can’t do this anymore,'" said Chris Kuehl, an economist with Armada Corporate Intelligence.
Here’s one way to think about it: let’s say a line of kids in an ice cream shop represents Medicaid recipients.
They have been getting federal funding to afford care. Or in this case, we’ll say allowance money based on doing their chores.
But in the latest version of the Big Beautiful Bill, there are stricter regulations and work requirements aimed at eliminating waste and fraud.
So, in our analogy, let’s say some of these kids didn’t do their chores, and they’re now getting their ice cream money taken away.
That’s an issue for those kids who were counting on that ice cream, but it’s also an issue for the ice cream shop, or in the case of the country’s budget bill, Medicaid providers.
That's because economists say when it comes to getting paid, whether it's ice cream or health services, that's less money coming in for those providers.
"If that is a significant reduction in reimbursement, I may have to decide that I can't accept Medicaid anymore because it doesn't make business sense. Where do my patients go?" said Ryan Jolly, a nurse practitioner who not only accepts Medicaid at her practice, but also relies on Medicaid for her own five children with disabilities.
Some of our senators who originally said they would not support Medicaid cuts ended up voting for the bill.
One of the most vocal opponents initially among Republicans, Missouri U.S. Senator Josh Hawley, pointed to the latest version of the bill that gives more money to rural hospitals as compensation when asked about his change of heart.
When we reached out to him earlier in the week, the Senate vote was still pending, so his press team said he was unable to do an interview. But, he and his team did provide a statement that read in part, “… with the delay in the provider tax framework that we were able to get and with the changes to the rural hospital fund, Missouri’s Medicaid dollars will actually increase over the next four years.”
But will that be enough to keep the doors open for providers? That remains to be seen.
When we reached back out to economist Chris Kuehl, he explained, "Most of the analysis I have seen is still pretty tentative as everybody tries to digest the changes. But, the speculation is that rural hospitals will not come out ahead. These hospitals are very dependent on Medicaid. Half of rural residents are on Medicaid. Many have assumed that Medicaid is concentrated in poor, urban communities, but the reality is that Medicaid concentrates in the rural areas."
Kuehl also shared with us that in addition to impacting providers who accept Medicaid, there is also an enforcement component of the Big Beautiful Bill.
With work requirements for Medicaid recipients, employees will be needed to make sure those requirements are being fulfilled. And traditionally, Medicaid offices have been understaffed. This could mean added work for those offices, which could slow down services you receive if you’re on Medicaid.
