We lead UofL Health. Medicaid cuts threaten lives, jobs and Kentucky's future
As the leaders of one of Kentucky's academic health systems, we have the privilege — and the responsibility — of witnessing firsthand how health care shapes lives, strengthens families and sustains communities. At UofL Health, we care for patients from every walk of life, many of whom rely on Medicaid for access to care. We also train the next generation of physicians — preparing them not only to treat illness, but to lead with compassion and innovation.
That dual mission is now under threat.
Recent Medicaid cuts passed by Congress, and signed by the president, present an alarming future for Kentucky's health care system. Some cuts will happen quickly, with the most severe cuts starting in 2028. With the implementation of this legislation, we expect to see access to care reduced, thousands of jobs eliminated and a deepening of the state's already dire physician shortage.
Hospitals and clinics will close, people who could have been saved will die
The Medicaid funding in this legislation falls far below the actual cost of providing care. Hospitals, clinics and physician practices — particularly those in rural and underserved urban areas — will be forced to close or cut back services just to survive. Kentucky already ranks among the least healthy states in the country. This legislation would only widen the gap between need and access. Additionally, as locations close, travel times and wait time will rise as access issues impact those who are not even part of the Medicaid system. Diagnoses will be delayed for all Kentuckians. Conditions will worsen, care will become even more costly as diseases advance and people who could have been saved will die.
Opinion: McConnell, KY has too much to lose if Medicaid is cut. We won't 'get over it.'
But the impact doesn't stop there. To match the services that remain, health care systems across Kentucky will be forced to make difficult decisions about staffing. The Kentucky Hospital Association has estimated a loss of 33,000 health care jobs — more than one-third of our state's health care workforce. The ripple effects on local economies and families would be severe. More importantly, the loss of skilled professionals will leave patients with fewer places to turn, fewer hands to help and fewer experts to trust in moments of critical need.
Medicaid cuts will add to doctor shortages
And then there's the future. By 2036, the U.S. is already bracing for a shortfall of 86,000 physicians. In Kentucky, where shortages are even more acute, we cannot afford policies that make it harder to train doctors and other health professionals. Yet these Medicaid cuts would do just that — reducing funding for residency slots and stifling opportunities for physicians, nurses and countless more clinicians who want to serve rural and underserved communities. As an academic health system, UofL Health plays a critical role in supporting these communities by training and deploying physicians, nurses and other providers equipped to provide care closer to home. Without a strong health care workforce, both access to life-changing care and innovation of new treatments will suffer.
These aren't just budget cuts. They are cuts affecting people's lives, their livelihoods and their hopes for a healthier tomorrow.
Opinion: Think Kentucky Medicaid cuts won't affect you? Think again.
We have dedicated countless hours working with members of Congress and their staffs, helping them understand the deep and lasting consequences these Medicaid cuts will have on Kentucky families. But despite our efforts, the final version of the legislation is worse than we feared. Calling it 'drastic' is an understatement. These changes threaten to upend health care in Kentucky for generations to come. Still, we are not giving up. We will continue to fight for Medicaid policy and funding that is right and just – for our commonwealth, our people and our future. We remain committed to reversing this harm and restoring the kind of support that builds a healthier Kentucky.
Health care is not just an expense line — it is the foundation of strong communities. Let's treat it that way.
Tell us what you think: Submit your letter to the editor here
Gerry Bradley is the UofL Health board chair, and Jason Smith, MD, is interim CEO of UofL Health.
This article originally appeared on Louisville Courier Journal: Medicaid cuts threaten Kentucky's health care system | Opinion
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