In 2018, Utah voters overwhelmingly chose to expand Medicaid, giving more than 350,000 Utahns access to affordable healthcare. But with President Donald Trump’s “One Big Beautiful Bill” recently signed into law, advocates in Utah say that progress is in danger of being reversed.
In a post on X, Rep. Mike Kennedy, who is also a family doctor and authored several Medicaid reform provisions that made it into the bill, said he was grateful to see key elements of his proposal included.
The final version of the bill both tightens Medicaid eligibility requirements and adds administrative hurdles to the program. The new provisions will allow states to impose work requirements, block automatic re-enrollment, require quarterly income verification, and require proof of citizenship or legal immigration status before enrollment.
"The One Big Beautiful Bill proves we don’t have to choose," Kennedy wrote. "We can protect those in need and stop the waste."
But Evan Done, the advocacy and public policy director at Utah Support Advocates for Recovery Awareness is less than convinced. His organization helped form the Protect Medicaid Utah coalition, a group of more than a dozen nonprofits fighting proposed state and federal cuts.
“I work in the behavioral health space," he explained. "Medicaid is the biggest payer for behavioral health services across the state, and so implementing things like work requirements not only don't make sense and have not worked in states where they've been tried, but it really speaks to the cruelty of this approach, and that there’s not a lot of thought put into the actual well-being of the lives that are going to be impacted.”
Done stressed that Medicaid’s impact goes far beyond just behavioral health. In rural Utah, where one in seven people rely on Medicaid, he said the stakes are especially high.
“One of the major threats is seeing those rural hospitals disappear," he said, "and then people wouldn't have healthcare facilities within a close proximity to where they live anymore.”
Done also said four in seven nursing home residents are on Medicaid. On top of that, nearly half of Utahns on the program are children.
“So we're talking about a lot of kiddos that get their healthcare coverage because of Utah's Medicaid program," he explained, "and that's about 18% of all Utah children.”
Done said he was frustrated to see several members of Utah’s federal delegation supporting Trump’s bill — especially given its projected impact.
“That is deeply disturbing to me as a Utahn and as an American," he said. "I would hope that our elected officials would want to do right by the people of Utah, and it doesn't seem like they're doing that right now. … Medicaid is a program that just provides health care coverage. People are not getting a check in the mail. They're not profiting off of Medicaid in any way. They're just getting their health care needs met, and so this is the population of people that are super vulnerable to these kinds of changes.”
Done added that those interested in joining the effort to protect Medicaid — whether as an organization or just as an individual — can go to protectmedicaidutah.org to learn more.
