Medicaid cuts pose GVH threat

Following a summer of sweeping federal health-care funding cuts, Gunnison Valley Health (GVH) CEO Jason Amrich addressed Gunnison County Commissioners on Sept. 9 to outline how the hospital is preparing to adapt.

Despite facing funding reductions and tighter Medicaid eligibility rules, Amrich said GVH is well-positioned to navigate the changes. But instead of cutting costs and services, he said the challenges pose an opportunity to grow and adopt an “abundance approach.”

“There have been a lot of knee-jerk reactions, like ‘let’s cut our way to prosperity, cutting staff, cutting programs, reducing hours,’ and we label that the scarcity approach,” Amrich told commissioners. “Instead, is there a way to grow through these challenges? Can we provide additional services needed by the community? Our abundance approach is, ‘what do we provide? Who do we partner with? Are there opportunities to collaborate with other health systems?’”

National Medicaid cuts

In July, H.R.1 — also known as the “One Big Beautiful Bill Act,” (OBBBA) — cut over $793 billion from federal Medicaid funding and reshaped Medicaid eligibility and reimbursement.

Even before OBBBA, Coloradans struggled with Medicaid renewals post-pandemic, ranking 46th out of 50 states, according to Amrich. Under OBBBA, Medicaid eligibility checks will now occur every six months instead of annually, and a work requirement of 80 hours per month is needed to maintain eligibility. Additionally, undocumented individuals will be barred from Medicaid coverage. The Colorado Department of Health Care Policy and Financing estimates 377,000 Coloradans could be at risk of losing coverage due to the new eligibility requirements, and an additional 21,000 undocumented individuals could lose coverage.

The National Rural Health Association projects a 21% loss of Medicaid funding for rural hospitals. For context, in 2024, GVH’s total patient revenue was $84 million. Medicaid comprised 11.4% of the payer mix, or roughly $9.4 million. GVH estimates that a 21% loss of Medicaid reimbursement would result in a nearly $2 million reduction in revenue every year, and that number doesn’t account for uncompensated care for patients who lose Medicaid eligibility.

“If folks are losing their health insurance, they're going to stop preventative care, routine care and start accessing the health system when they're only in crisis,” Amrich said at the meeting. “They will come to GVH, we will treat them and take care of them. But of course, that will turn into more uncompensated care for the organization.”

Rural hospital trends

The cuts to Medicaid pose an additional challenge to rural hospitals in the United States. To date, nearly 48% of rural hospitals have a negative operating margin, and over 400 are vulnerable to closure, according to GVH. There are also growing “care deserts” for OB-GYN and chemotherapy. Between 2011 and 2023, nearly 300 hospitals stopped offering OB-GYN services, and over 400 hospitals closed chemotherapy services in the last ten years, according to GVH.

Last year, GVH delivered 134 babies, held 18,000 primary care visits and 17,000 oncology appointments, with many including chemotherapy treatment. Demand has increased in 2025, with primary care visits jumping to 25,000, and urgent care growing to 6,000 visits. 

“[These trends] signify that GVH is providing a valuable service to the community, and we are continuing to grow alongside community demand,” said GVH Board of Trustees Chair Mark Kaufman at the meeting.

Abundance versus scarcity

Despite the mounting challenges, Amrich said GVH is better positioned to weather the national changes than other rural hospitals because of an experienced management team and strong clinical care. Instead of cutting costs and staff, GVH will respond by expanding service lines and incentivizing the Gunnison community to seek care in the valley instead of travelling to other hospitals. This year, GVH added dermatology services, cataract and mohs surgery and orthopedic subspecialist services — care that would previously require a significant drive and longer wait time. 

“While we definitely think it's incumbent upon the GVH management team to make sure that we're efficient and that we're a good steward of our resources, we believe that an abundance mindset is going to set us apart, and enable GVH to thrive, and weather this storm,” Amrich said.

(Alex McCrindle can be contacted at 970.641.1414 or alex@gunnisontimes.com.)