UofL Health leads the fight against Medicaid cuts threatening lives and Kentucky's future

The Critical Role of Medicaid in Kentucky’s Health Care System

As leaders of one of Kentucky’s academic health systems, we have the privilege and responsibility of witnessing how health care shapes lives, strengthens families, and sustains communities. At UofL Health, we serve patients from all walks of life, many of whom depend on Medicaid for access to essential care. We also play a vital role in training the next generation of physicians, preparing them not only to treat illness but to lead with compassion and innovation.

This dual mission is now under serious threat. Recent changes to Medicaid funding, approved by Congress and signed into law, pose a significant risk to Kentucky’s health care system. These cuts will have far-reaching consequences, impacting not just those who rely on Medicaid, but all Kentuckians.

Immediate and Long-Term Consequences of Medicaid Cuts

The Medicaid funding reductions outlined in this legislation fall well below the actual cost of providing care. Hospitals, clinics, and physician practices—especially those in rural and underserved urban areas—will be forced to close or reduce services simply to survive. This will lead to a decrease in access to care, with thousands of jobs lost and a worsening of the state's already severe physician shortage.

Hospitals and clinics may be forced to shut down, which could result in preventable deaths. As locations close, travel times and wait times will increase, affecting everyone, even those not enrolled in Medicaid. Delayed diagnoses will become more common, leading to worsened conditions and higher costs as diseases progress. People who could have been saved may lose their lives due to these systemic failures.

Impact on Health Care Workforce and Local Economies

The effects of these cuts extend beyond access to care. To maintain the remaining services, health care systems across Kentucky will need to make difficult staffing decisions. The Kentucky Hospital Association has estimated that up to 33,000 health care jobs could be lost—more than one-third of the state’s health care workforce. This loss will have severe ripple effects on local economies and families, especially in rural areas where health care jobs are often a primary source of employment.

More importantly, the loss of skilled professionals will leave patients with fewer options for care, fewer hands to help, and fewer experts to trust during critical moments. The impact on patient outcomes will be profound, particularly for those in vulnerable communities.

A Growing Physician Shortage

Looking ahead, the U.S. is already preparing for a projected shortfall of 86,000 physicians by 2036. In Kentucky, where shortages are already acute, these Medicaid cuts will only exacerbate the problem. The legislation reduces funding for residency slots and limits opportunities for physicians, nurses, and other clinicians who want to serve rural and underserved communities.

UofL Health plays a crucial role in addressing these challenges by training and deploying health professionals who can provide care closer to home. Without a strong health care workforce, both access to life-changing care and the development of new treatments will suffer. This is not just a budget issue—it is a matter of life and death.

A Call to Action

We have spent countless hours working with members of Congress and their staff to highlight the deep and lasting consequences of these Medicaid cuts. Despite our efforts, the final version of the legislation is worse than anticipated. Calling it “drastic” is an understatement. These changes threaten to disrupt health care in Kentucky for generations.

Still, we remain committed to fighting for Medicaid policies that are fair and just. We will continue to advocate for funding that supports our communities, our people, and our future. Our goal is to reverse this harm and restore 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.