Medicaid changes unlikely to impact healthcare center

BUFFALO — As the dust settles in the wake of the passage of President Donald Trump’s “One Big, Beautiful Bill” – the massive budget package signed into law early this month – Johnson County Healthcare Center CEO Luke Senden said that Wyoming hospitals may experience fewer impacts from the bill than others nationwide.

That’s because Wyoming is one of 10 states that did not expand Medicaid coverage under the Affordable Care Act.

“Generally, across the country, this could be a huge hit for vulnerable hospitals,” Senden said. “But I think in the state of Wyoming, we’re going to be pretty fortunate. I don’t think that we’re going to have the impact that other states are, largely because we didn’t receive increased (Medicaid) funding that we’re now having taken away from us.”

The Congressional Budget Office projects that the bill will reduce federal Medicaid spending by $793 billion over 10 years, resulting in 10.5 million fewer people enrolled nationally. Changes include increased work requirements and potential penalties for states that have expanded Medicaid.

The Wyoming Medicaid program covers 62,000 patients.

Senden said that historically, about 50% of the residents of Amie Holt Care Center are Medicaid beneficiaries. But he’s not concerned that the new provisions in the bill will affect residents’ Medicaid eligibility or the care center, because one of the most significant changes to Medicaid is the addition of work requirements for able-bodied adults younger than 65. Most of the care center residents are either over age 65 or have medical conditions that would exempt them from the work requirement.

“We really won’t be impacted from that population as a whole,” Senden said.

Though the fact that the local hospital is unlikely to feel major impacts from the changes to Medicaid is positive, Senden said that any time people lose health insurance – whether government or private pay – the concern is that patients will be sicker when they do seek care and require more intensive and expensive treatment.

“When people don’t have health care as a whole, they tend to stay home longer,” he said. “That’s part of the push for annual wellness visits and just getting people in the door more frequently, because early detection can help keep the cost lower. We want to treat major health issues faster, before they become more problematic.”

For hospitals, uninsured people are often a source of uncompensated care – care that the hospital is never paid for.

Medicaid provides insurance for a “vulnerable population,” and though the coverage doesn’t cover the total cost of care, “it’s better than hospital systems doing that work for free,” Senden said.

In January, U.S. Sen. John Barrasso, R-Wyo., brought up the challenges of rural health care to Robert F. Kennedy Jr., who is now U.S. secretary of Health and Human Services.

Barrasso said six Wyoming hospitals are at risk of closing, two are in immediate risk of closing in the next two years, and 10 have had to cut available services, according to a news release from his office.

“We have 33 hospitals in Wyoming. Twenty-six are located in various locations often hard to get to, or weather impacts them,” Barrasso said.

“This is a concern of rural hospitals in both Republican and Democrat states. It’s bipartisan. It is critical that the financial, workforce challenges that we are facing are addressed.”

Johnson County Healthcare Center is not among those hospitals at risk of closing, but Senden said that federal and state decisions do add up and they can impact a hospital’s financial viability. 

Senden said that already many Wyoming hospitals will lose out on some property tax dollars due to property tax reductions approved by the Wyoming Legislature this winter.

“Those little impacts make a huge, huge impact on the viability and sustainability of those organizations as a whole,” he said.

He added that Wyomingites should be mindful of the challenges rural hospitals in particular are facing and not become complacent.

“We’re not far away in the state of Wyoming from having what they call ‘health care deserts,’ and we’re pretty spread out as a state. So you lose a hospital, like Rawlins, and there’s 100 miles of interstate without a health care provider,” he said.

“There’s some real impact that that’s going to have. Even if this is not the worst news and other states are having much more dire conversations, I always think it’s important for us to have a realistic understanding that hospitals close around the country every single year,” said Senden. “One hospital in the state of Wyoming is crucial to providing care for the residents, so I think we always need to be mindful that we’re protecting these critical resources and the impacts they have inside of our communities and our state as a whole.”

This story was published on July 17, 2025.