How Medicaid cuts may affect thousands of Utahns’ health care

Christie Sorenson was 23 and uninsured when she was diagnosed with non-Hodgkin lymphoma in 2014.

A nine-day stay in the hospital cost about $80,000, she said, and her six chemotherapy treatments that followed cost $20,000 each. Unable to work, Sorensen said she also accrued significant other debt in order to pay for groceries, gas and other living expenses.

It was only thanks to Medicaid, the low-cost government-sponsored health insurance program, that Sorensen was able to access coverage for her care. Vitally, she said, she was able to access the program about two and a half months after she first went in for care, thanks to the three months of retroactive coverage allowed under Medicaid.

Today, Sorensen is in remission and volunteers with the American Cancer Society Cancer Action Network, and she’s been raising the alarm about proposed cuts to the program that saved her life.

A recent bill passed by the U.S. House would limit retroactive reimbursement under Medicaid to just one month, as well as, for the first time, impose national work requirements and increase eligibility checks for some Medicaid beneficiaries. It would also ban the use of Medicaid funds to cover gender-affirming care for transgender people and cut federal funding to states that provide health care to undocumented immigrants.

“It kind of scares me to think back [about] how it could have played out differently,” Sorensen, who lives in West Valley City, said in an interview. “If cuts had taken place, then I would have been left without treatments. My tumor would have kept growing, and, worst case scenario, I would have passed away.”

The cuts to Medicaid funding are part of the “One Big Beautiful Bill Act,” a wide-ranging budget package, which includes, among other things, an extension on tax cuts instituted during President Donald Trump’s first term, an expansion of the Child Tax Credit, and a requirement that states increase their contribution to the Supplemental Nutrition Assistance Program (SNAP).

Additionally, under the House bill, Congress would also allow for the expiration of enhanced premium tax credits that help thousands of people afford health coverage through the Affordable Care Act and tighten restrictions on the program – a flagship achievement of former President Barack Obama’s administration.

The “big beautiful bill,” as Trump has been calling the legislation, requires the approval of the U.S. Senate, where additional changes are expected, before it can become law. As currently constructed, it would reduce federal spending on Medicaid by $600 billion over the next ten years.

Currently, more than 80 million Americans receive their health care through Medicaid, and 24 million more get their health care through the Affordable Care Act, according to the health policy nonprofit Kaiser Family Foundation. Between the proposed changes to the two programs, the Congressional Budget Office (CBO) estimated that something like 10 million people across the country could lose health coverage.

In Utah alone, by the estimation of the Congressional Joint Economic Committee’s Democratic staff, 31,000 Medicaid recipients could lose access to the program, along with another 109,000 who stand to lose ACA coverage.

All four members of Utah’s all-Republican congressional delegation voted for the bill.

‘Deeply cruel’ cuts

“The bill threatens the dignity of Utah families,” said Thaiss Del Rio, a policy analyst for the children’s health advocacy group Voices for Utah Children. “It creates barriers where there should be support, and it will shift costs and confusion onto the very people who need care the most.”

Voices for Utah Children is one of 15 Utah organizations, including the American Cancer Society Cancer Action Network, who have banded together in recent weeks to form the Protect Medicaid Utah Coalition, which aims to fight back against the proposed legislative reforms.

Nate Crippes of the Disability Law Center, another member of the coalition, said the proposed cuts to Medicaid would have an outsized effect on some of Utah’s most in need populations. According to Crippes, the organization’s public affairs supervising attorney, 60% of Utahns enrolled in Medicaid under the 2019 expansion have a behavioral health need, including an estimated 30,000 with a mental illness and 19,000 with a substance use disorder.

“If you impose work requirements or continuous eligibility checks that are more frequent, you’re going to run into people losing coverage and not accessing the services and continuing to cycle through [the criminal justice system],” he said. “The reason it’s a cost savings for the federal government is because people lose coverage.”

Evan Done of Utah Support Advocates for Recovery Awareness shared this concern.

“Having to do that is pretty complex, especially for somebody who’s in the middle of a behavioral health crisis,” he said. “Either it’s active substance use or maybe it’s depression or post-traumatic stress disorder. All those kinds of conditions can prevent people from engaging meaningfully in a process to help them.”

The “Big Beautiful Bill” also takes aim at Utah’s Children’s Health Insurance Program (CHIP), which Utah uses to provide coverage for some immigrants regardless of their legal status. Despite the fact that no federal dollars are used to fund the program, the proposed Congressional budget also includes penalties for Utah and 13 other states that would slash billions of dollars in funding unless they roll back the programs.

“Punishing all Utahns because the state chose to provide children with access to health care is deeply cruel,” Del Rio said. “Utah’s decision to cover all income-eligible kids, regardless of their immigration status, was a bipartisan effort grounded in common sense and compassion.”

Congressional support for the ‘big beautiful bill’

The “One Big Beautiful Bill Act” passed the House last month by just a single vote — 215-214 — as two Republicans joined with Democrats to vote against it. Utah’s U.S. House delegation — which includes Republican Reps. Blake Moore, Celeste Maloy, Mike Kennedy and Burgess Owens — voted in favor. Owens and Maloy did not respond to repeated requests for comment on the legislation.

Kennedy, who represents Utah’s 3rd congressional district, said he thinks the Medicaid reforms are important cuts to a ballooning program.

“The Medicaid provisions included in the reconciliation package aim to restore the program’s original purpose: providing critical support to those truly in need,” Kennedy, a doctor by trade, said in a statement to The Salt Lake Tribune. “Currently, taxpayer resources are being stretched to cover illegal aliens as well as able-bodied adults. Government programs are designed to be temporary, encouraging a path toward self-sufficiency while continuing to offer temporary assistance.”

Medicaid benefits are not available to people in the United States illegally.

Moore made similar remarks in a statement to The Tribune. The goal of the Medicaid portion of the bill, he said, “is to ensure the program remains solvent for future generations and continues to serve its traditional target population.”

“Republicans are ensuring that Medicaid’s limited resources are focused on those for whom it is intended: low-income pregnant women, children, seniors, and those with disabilities,” Moore said. “The bill’s work requirements — proof of part-time work, community service, or qualifying educational opportunities — only apply to the expansion Medicaid population and those who are able-bodied with no dependents, not the traditional population.”

Malloy, in a video to constituents, said, “Many of the reforms being made, like introducing work requirements for able-bodied adults without dependents, won’t harm those that truly rely on Medicaid, but it also makes sure that only American citizens who are in need reap the benefits of the program.”

Owen, on social media, said the bill showed Republicans were keeping their promises and were supporting Trump’s agenda.

Members of the Protect Medicaid Utah coalition said that in meetings with members of the delegation, including Kennedy, they have heard similar arguments about rooting out waste, fraud and abuse in the program via the proposed cuts.

“I don’t object to the idea that there’s potential for cost savings in rooting out fraud, waste and abuse,” Done said, but he added that he doesn’t think the bill achieves that goal. While many health care providers are good actors, he said, “the vast majority of Medicaid fraud that occurs occurs on the provider side.”

Crippes agreed, and pointed to recent KUER and Utah Investigative Journalism Project reporting about how practices at a rural hospital in Beaver that received hundreds of millions in Medicaid funding could now cost the state millions. Crippes also said he’s concerned that the administrative burden of implementing the proposed restrictions could be costly for the state.

The bill now awaits a vote in the Senate, where Utah Sens. Mike Lee and John Curtis will weigh in.

Lee did not respond to a request for comment for this story, but has said publicly that he opposes the bill in its current form, as he feels spending cuts included in the legislation are not enough.

“We [have] got to address the spending crisis to a greater degree than this bill does,” Lee said during a podcast appearance last month. “Under the CBO projections, we’re still looking at $2.2 trillion a year on average in deficits over the next ten years. That’s not good enough. We gotta get to a point where we can balance it during this president’s time in office.”

A spokesperson for Curtis did not offer specifics about where the senator stands on the legislation and pointed to brief comments the senator shared in recent weeks.

“Targeted reforms are essential if we want to make sure programs like Medicare and Medicaid can continue to serve those who need them most,” a post from the senator on X read. But Curtis’s office did not offer specifics about what those targeted reforms might include.

“The House has spoken, and now the Senate will have its chance,” the spokesperson added.

Sorensen said she hopes Curtis, in particular, will hear and share the concerns she and other coalition members have been raising.

“I was one of the lucky ones, and I’m able to share my story,” she said. “There are other people who are not so lucky. Cuts are just not the answer. It’s critical health care insurance that’s getting denied to thousands of Utahns, so we’re just really hoping that Senator Curtis just votes no.”

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