Older adults at high risk under Medicaid cuts, experts say
CHEYENNE — “This is a critical time in the fight to protect health care access and affordability for everyone.”
That’s what Healthy Wyoming Interim Executive Director Jenn Lowe said during a webinar Thursday night, as she and other health care experts detailed the risk potential Medicaid cuts pose to hospitals, nursing homes and Wyomingites.
“Wyoming residents already face among the highest health care costs in the country,” Lowe said. “By cutting Medicaid funding, Congress is forcing providers to increase their costs, driving up the price of health care for all.”
The House Committee on Energy and Commerce passed a reconciliation bill Wednesday, with a 30-24 vote, that proposes $715 billion in cuts to Medicaid. The Kaiser Family Foundation estimates at least 13.7 million people across the country will become uninsured by 2034 under the proposed changes, according to estimates from the Congressional Budget Office.
The webinar was hosted by Healthy Wyoming and Better Wyoming. A panel of health experts explained how Medicaid cuts would impact different areas of the state’s health care industry.
However, one panelist was missing. Casper resident Angela “Angie” Dax was a longtime advocate for Medicaid expansion in the Equality State. She was one of thousands of Wyomingites living in the Medicaid gap, unable to afford treatment for her chronic health conditions, but she didn’t qualify for Medicaid coverage. The gap exists because the state did not expand its Medicaid program.
Dax died May 3 while in hospice care, after years of battling pulmonary hypertension, a disease that affects the heart and lungs.
“A true Medicaid expansion champion, she will be greatly missed,” Lowe said. “But I know she would want us to keep working for the health care access that so many like her desperately need.”
Nearly 63,000 Wyomingites receive insurance through Medicaid and the Children’s Health Insurance Program.
One in three children and one in 14 senior citizens in Wyoming fall within this population, according to Healthy Wyoming.
Yet, children, vulnerable adults, people with disabilities and senior citizens stand to lose the most if major changes are made to the $900 billion federal health care program, experts said Thursday night.
“Everyone should be alarmed,” Lowe said. “It is impossible to cut this much this fast without terminating care for millions who need it. Despite what our members of Congress are saying, these policy changes will impact Wyoming in a negative way.”
Impact on older adults
More than 70% of nursing homes in the state are covered by Medicaid, health experts said during Thursday’s webinar. Wyoming Medicaid reimbursement rates cover 65-72% of the total cost of care, according to a December 2022 memo from the Wyoming Department of Health.
Lisa Osvold, who worked in the state Department of Health’s Aging Division before retiring, said two thirds of nursing home residents rely on Medicaid. Facilities may be forced to close under the proposed Medicaid cuts, displacing dozens of older adults, she said.
“Not all older adults have family members who can become caregivers,” Osvold said. “For those elder orphans, Medicaid-funded services aren’t just supplemental, they’re the entire support system.”
Osvold listed three other, unique vulnerabilities in Wyoming that put older adults “especially at risk when Medicaid funding is threatened.”
First, the state’s rural features create geographical barriers in access to care, she said. Older adults who can’t drive rely on non-emergency medical transportation to get them to the nearest provider, which could be hours away.
“Since this service is not a mandatory service in Medicaid, my concern is that it could be reduced or eliminated totally with funding cuts,” Osvold said. “And, as you can imagine, this would be very difficult for our older adults.”
Second, Wyoming already faces a “significant” shortage of physicians, she said. Multiple counties have zero physicians, and several others have five or fewer physicians that serve coverage areas of thousands of square miles.
“Our rural facilities operate on very thin margins as it is,” Osvold said. Even a small reduction in reimbursement “can trigger cuts or closures.”
Finally, Wyoming has one of the fastest-aging populations in the country. Currently, more than 20% of the state’s rural population is 65 and older. Osvold said this creates a growing demand for services. Around 90% of older adults have one or more chronic conditions, which requires ongoing care, she said.
“Many assume Medicare covers all senior needs, but it really doesn’t,” Osvold said. “It provides almost no coverage for long-term care or home-based services.”
Keeping independence
People with disabilities are disproportionately at risk of living at or below the federal poverty level, said Wyoming Independent Living Executive Director Amy Burns. WIL is a nonprofit with offices across the state that support people with disabilities.
“Many people with disabilities have complex medical needs while living on a fixed income,” Burns said. “Medicaid is a crucial component of healthy living for these individuals.”
Wyoming Medicaid funds home- and community-based services that serve more than 2,800 individuals who would otherwise qualify for nursing-home level care. It also funds skilled and clinical nursing assistants, home health, clinics and transportation.
“These programs provide in-home support that prevent unnecessary institutionalization in nursing homes or state hospitals,” Burns said.
Medicaid waivers fund services and programs that allow these individuals to live at home and keep their sense of independence.
Cuts to these services will increase the financial burden of people with disabilities who already live on a limited income and will force many to move into an institutional setting, she said.
In addition, if Congress were to allow premium tax credits to expire this year, many folks — including those who work in the nonprofit sector — will face significantly higher insurance costs. Premium tax credits are a federal subsidy that make insurance more affordable on the federal health insurance marketplace.
“These are not particularly high-paying jobs. We do it because we love the work,” Burns said. “If I were to lose my tax credit, my health care premiums for myself and two children would be 35% of my income.”
Nearly 47,000 Wyomingites receive their health insurance through the federal marketplace. Out of this number, 95% of these individuals receive a premium tax credit, said Amy Spieker, who works with Laramie County Community Partnership and at Cheyenne Regional Medical Center.
If Congress chooses not to extend premium tax credits, “the average premium for Wyoming health insurance marketplace users will increase 194% in 2026,” Spieker said.
“The expiration of these tax credits will impact Wyoming small business owners,” she said.
This story was published on May 17, 2025.