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Kentucky faces big Medicaid cuts under Trump's bill

What's on the Line for Kentucky?
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FRANKFORT, Ky. (LEX 18) — Estimates show many Kentuckians might lose healthcare coverage as federal spending on Medicaid faces deep cuts.

President Donald Trump's "One Big Beautiful Bill" could reduce federal Medicaid spending by $1 trillion, according to new congressional budget office estimates. That could potentially devastating Kentucky's healthcare system and economy, according to policy experts.

"It seems really dire. These cuts are really significant," said Dustin Pugel, the policy director at the Kentucky Center for Economic Policy.

Pugel estimates approximately 210,000 Kentuckians could lose their healthcare coverage over the next 10 years.

"That would just about double our current rate of uninsured here in the state and that really means that not only are those folks not able to see a doctor or take medicine without breaking the bank, that money is no longer coming into the state. That represents about $28 billion in Kentucky," Pugel said.

The impact would extend beyond individual healthcare coverage. Rural hospitals across Kentucky could be forced to close, with some estimates suggesting about 35 facilities might shut down, eliminating both healthcare access and jobs in vulnerable communities.

"There are 90,000 Kentuckians that work in hospitals in the state. Those incomes are about $10,000 higher than the average income here in the state. And when they lose their jobs, particularly in rural areas, you're talking about entire local economies suffering, not just those places," Pugel said.

The situation could worsen as the bill fails to extend expanded federal subsidies that have helped many middle-class Kentuckians obtain insurance through the state's insurance marketplace. This could result in an additional 47,000 people losing insurance coverage, beyond the 210,000 who would lose Medicaid, according to Pugel.