Mark Bennett: Vigo's high number of Medicaid enrollees means cuts will be felt here

If any Hoosier community could stand as a poster child for the impact of Medicaid cuts, Vigo County would be it.

The cutbacks came in legislation enacted by Congress and signed on July 4 by President Donald Trump. That “One Big Beautiful Bill Act,” as Trump named it, will trim $1 trillion over the next decade from the federal Medicaid program, the Affordable Care Act and the Children’ Health Insurance Program, The Associated Press reports.

The nonpartisan Congressional Budget Office projects those changes will result in 10.9 million people nationwide losing health insurance coverage, according to the Kaiser Family Foundation.

Along with that, the expiration of the Affordable Care Act’s enhanced premium tax credits will boost the total number of uninsured Americans to 16 million by 2034, KFF concluded.

Medicaid is a public-funded health insurance program for low-income Americans, including the disabled and elderly, and children. Its funds — through federal, state and local governments — pay most or all of Medicaid recipients’ healthcare costs. States operate their own Medicaid programs, such as the Healthy Indiana Plan.

Approximately 1.8 million Hoosiers are enrolled in Medicaid (and the Children’s Health Insurance Program or CHIP), KFF data from 2024 shows. A significant portion of Medicaid enrollees live in Vigo County.

Vigo has the second-highest percentage of residents enrolled in Medicaid among Indiana’s 92 counties — 25.7% or 1 in 4 people, according to 2023 data from the Center for Children and Families at Georgetown University McCourt School of Public Policy. Only Marion County at 25.8% ranks higher.

Vigo also ranks sixth-highest for kids enrolled in CHIP at 41.3% and fourth for senior citizens at 16.5%. And, among non-senior-age adults, Vigo County has Indiana’s highest percentage of Medicaid enrollees — 21.7%.

Trump and supportive lawmakers in his Republican Party say the Medicaid cuts will reduce waste and fraud. Democrats, including those in Indiana, insist the law cuts taxes for the wealthiest Americans while reducing access to health care for low-income people. Regardless, the result could mean fewer services, longer waits and perhaps a loss of coverage for Hoosiers on Medicaid.

The cuts could also force hospitals and clinics to reduce care, eliminate services or even close. Thus, Hoosiers with private healthcare coverage could feel the cuts, too, Katherine Hempstead — senior policy officer at the Robert Wood Johnson Foundation — said in a phone interview Thursday. The RWJF is a philanthropic health equity analysis organization.

Especially in a county with such a high percentage of Medicaid enrollees.

“It’s going to ripple through your community,” Hempstead said.

The rates of residents going into debt to pay for medical necessities could rise, she said. Medicaid cuts could manifest in less obvious ways if those most affected start buying groceries on credit cards or going to emergency rooms for non-emergency medical needs, Hempstead added. The impact of the new law’s reduction in Medicaid compensation to hospitals could not only force those facilities to reduce services, but hospitals may also experience greater difficulty in attracting physicians.

“While the people that lose their coverage are going to be hurt the most, there’s going to be a huge wave going through the entire community,” she said.

The new law also includes stricter work requirements for Medicaid recipients, and guidelines for states to verify their compliance.

According to KFF and the Pew Research Center, just over 31.2 million Americans ages 19 to 64 are enrolled in Medicaid. Of those, 2.4 million also are covered by Medicare, and another 2.7 million receive disability benefits from Social Security. Among the remaining 26.1 million Medicaid enrollees, about 9.5 million were not working a job full- or part-time; of those, 3.2 million cited caregiving duties that kept them from working, 1.7 million were students and 2.6 million cited illness or disabilities, Pew reported.

“There are very few people who could be working that aren’t while getting Medicaid,” Hempstead said.

Many could lose coverage because they’ll struggle to keep up the more frequent and stringent work-documentation requirements. “Most of the people losing their coverage will be people who are eligible for coverage,” Hempstead said.

From 2025 through 2034, Medicaid cuts in Indiana will amount to $30.9 billion, RWJF figures show, including a $12.7-billion reduction for hospitals. An estimated 180,000 Hoosiers will lose coverage. Many Vigo Countians could be among them.

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