State senator hosts roundtable on Medicaid

Healthcare officials came to Beebe Healthcare in Lewes Nov. 13, to discuss the challenges facing the industry in the wake of federal cuts to Medicaid.

A part of this year’s federal budget known as the One Big Beautiful Bill calls for large cuts to the Medicaid program, which uses federal and state funding to provide low-cost healthcare to individuals and families with low incomes, pregnant women, the elderly and people with disabilities, among other groups. These cuts are anticipated to especially hit rural healthcare facilities. Much of the onus for making up the federal cuts is likely to fall on the states. 

With that in mind, the panel was convened by Sen. Marie Pinkney, D-Bear, and included officials from state agencies, local hospitals, outpatient care facilities and the insurance industry. 

“What’s going to be most important in the years to come – plural – is going to be communication and collaboration with each other,” said Drew Wilson of the Medicaid and Medical Assistance Division of the state Department of Health and Social Services.

Wilson said there are 250,000 Delawareans enrolled in the Medicaid program. The mission, he said, is to provide high-quality healthcare that is affordable. Wilson said the federal cuts amount to about $880 million over the next 10 years, with most of the cuts coming from subsidies spelled out in the Affordable Care Act, which were put in to allow lower-income people to better afford insurance. Wilson said other areas targeted in the bill include abortion services provided under Medicaid and revenue coming from hospital taxes.

In 2024, Delaware enacted a law that would impose a 3.58% tax on hospital patient revenues, the goal of which was to use that revenue to bolster Medicaid funding. However, Wilson said, the new federal budget bill places restrictions on the use of that revenue, making it more difficult for the state to implement it as it was intended.

“We want to keep as many people in the program as possible,” he said.

For medical doctors, the biggest concern will be the domino effect the Medicaid cuts will have on patients seeking preventative care.

“When we look at the statistics in Sussex County, one in six residents of Sussex County relies on some kind of Medicaid program,” said Dr. Bill Chasanov of Beebe Healthcare. “When that’s reduced, the entire cost of their care is going to go up. They’re not going to their primary care. They’re not going to do their colonoscopy. They’re not going to get their flu vaccine. They’re going to end up in the emergency room extremely sick [because] they’re going to wait until the last minute. That’s the fear that’s instilled in all of us. How do we break that cycle?”

Dr. Vinay Maheswari of ChristianaCare echoed those thoughts.

“I’m very worried about the influx that will happen in terms of emergency care,” he said. “I think most of our emergency rooms are already at or near capacity, and this is going to be a major burden. Another area for us to think about is how we can build an urgent care network and get the word out to patients about their use.”

Beebe Healthcare CEO Dr. David Tam said the hospital has had to come up with ways to reduce costs in anticipation of federal spending cuts while also being able to grow. He said he is prepared for a world where people are using the ER for care more often, as growing networks statewide will take a lot of time, and also expanding services such as mobile clinics to better reach rural areas. 

Carolyn Petrak, executive director of Ability Network of Delaware, said one of the biggest areas that will be affected by Medicaid cuts will be people with disabilities and those in need of mental health care. 

Pinkney said her impression from the roundtable is that the conversation is broader than just Medicaid, and additional conversations are needed to try to come up with solutions.