At least a dozen Nebraska hospitals could be at serious risk of closing if Congress moves forward with proposed Medicaid cuts, health care administrators and hospital officials warned on Monday. The concern comes after the House of Representatives passed a Republican-backed budget resolution that includes $2 trillion in federal spending cuts over the next decade, with $880 billion coming from the committee overseeing Medicaid, a program that provides health coverage for more than 70 million low-income Americans, including around 350,000 Nebraskans.
While the resolution does not specify exactly where reductions will be made, Medicaid has been a primary target, with Republican leaders proposing work requirements and overall funding reductions. Health care advocates say these cuts could force many Nebraska hospitals, particularly those in rural areas, to eliminate services like maternity care and behavioral health—or shut down entirely.
At a press conference at the Nebraska State Capitol, Nebraska Hospital Association President Jeremy Nordquist urged the state’s congressional delegation to push back against the proposed cuts, emphasizing that more than 180,000 children in Nebraska depend on Medicaid. He warned that limiting funding would put critical services at risk.
Despite these concerns, all three of Nebraska’s Republican representatives—Mike Flood, Don Bacon, and Adrian Smith—voted in favor of the resolution. Bacon later stated that he was assured the final legislation would not negatively impact Medicaid recipients and that adjustments would be made before the bill is finalized.
Health care providers, however, remain alarmed. Amy Behnke, CEO of the Health Center Association of Nebraska, said Medicaid expansion cuts alone could strip health coverage from 10,000 patients and cost Nebraska’s community health centers $33 million in lost revenue, leading to service reductions or facility closures.
The impact would be especially severe for elderly Nebraskans. Nearly 60% of the state’s nursing home residents rely on Medicaid, and at least 12 nursing homes have closed in the past three years. Kierstin Reed, director of a nonprofit network focused on senior care, said more closures could be imminent if Medicaid funding is reduced.
Rural hospitals are particularly vulnerable, as nearly half of Nebraska’s Medicaid recipients live in rural areas. Jed Hansen, director of the Nebraska Rural Health Association, noted that Medicaid currently funds 44% of pediatric care provided in rural hospitals. He also pointed out that over the last two years, 20% of Nebraska hospitals have been forced to cut or eliminate services, and more than half of the state’s rural hospitals are already operating at a financial loss.
Roger Reamer, CEO of Memorial Hospital in Seward County, highlighted the challenges facing maternity care in rural Nebraska. Currently, only 20 of Nebraska’s 63 critical access hospitals still provide labor and delivery services, and in Seward, Medicaid covers a third of all births. Without proper funding, he warned, gaps in coverage will continue to grow.
The struggles Nebraska hospitals face mirror national trends. Over the past 20 years, nearly 200 rural hospitals have closed across the U.S., with more than 750 others considered at risk, according to a February report. Nebraska has already lost two rural hospitals since 2005, and three more were in immediate danger even before these proposed cuts.
Hansen summed up the situation simply: “It’s a numbers game in rural health care. A single funding cut could be the final blow for hospitals already on the edge.”
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