LAS VEGAS (KTNV) — Changes are coming to Medicaid that could impact hundreds of thousands here in the Silver State.
“I mean I would be concerned about that," said Las Vegas local Mark Potovsky.
Mark is 64 years old and uses Medicaid. He tells me he's just struggling to get by right now.
“I had a heart attack," Potovsky said. “I have type 2 diabetes and hypertension, and the stents in my heart."
He's not just struggling with his health; his financial situation is also not great.
“I’ve sold everything that I have of value just so I can continue to eat and to keep up with my bills," Potovsky said.
He's relying on Social Security and Medicaid to make it by.
So new changes coming to Medicaid could impact him and many Southern Nevadans.
WATCH| I tell you about a group trying to help Southern Nevadans with upcoming Medicaid changes:
“About 738,000 Nevadans who are covered by Medicaid and with these changes, we may lose about 115,000 of them ... so this is serious," said UNLV Health Las Program Director David Orentlicher.
Orentlicher says this all stems back to the One Big Beautiful Bill President Donald Trump signed on July 4.
That bill, now law, made changes to work requirements. Adults ages 19 -64 will now have to complete 80 hours of work or community service to qualify, with some exceptions.
Changes for non-U.S. citizens are also coming, limiting eligibility to some immigration statuses.
There will be more frequent eligibility reviews, now every six months. This means all paperwork required to keep Medicaid eligibility will have to be collected more frequently than before.
Plus, there are many other changes, including cost-sharing and limits to coverage, to name a few.
These all have varying dates of going into place, some in 2026 and others in 2027.
But, there are already some changes part of the bill that could impact Medicaid indirectly, already in effect now.
There is some help though. A group of local healthcare professionals came together to create Inspiration Health.
“We didn’t want to leave anyone in our community behind," said Inspiration Health President Rita Cole.
This is a subscription health service created out of a need they saw from these changes.
“We don’t require if they meet an income requirement or if they have another provider that’s covering for them, it’s none of that. What it simply is, is that our doctors in our community want to help our community out so we’re still going to see that patient," Cole said.
The service is currently active. The cheapest plan starts at $48 per month to $128 per month for a family of four. There are also plans for specialists available.
The monthly fee gives you access to a group of 39 providers that's growing. In order to see a doctor, there will be at least a $48 fee per visit and extra fees for specialists or scans, like X-rays. Low-cost prescriptions are also part of this service.
The providers part of the program usually serve Medicaid patients. Some are afraid that these new regulations that Medicaid users will not go to the doctors and not get the help necessary before it becomes an emergency, since they can't afford it.
It would not only force people into bad health, but also take away the financial stream for many of these local providers.
However, this issue is not just seen in Nevada; it's nationwide. Experts claim around 17 million people could lose their benefits after these changes take effect.
So, Inspiration Health is looking to expand, already having providers buying in for Texas, California, Arizona, Utah, Colorado and others.
“I’m glad to hear that doctors are looking for ways to fill the gap," Orentlicher said.
Mark tells me he just hopes this will truly help, saying Medicaid saved his life and he hopes it continues to do so for others.
I asked him where he thinks he'd be without Medicaid.
"Probably in a box in the ground, you know. Really, it’s a lifesaver, yes absolutely," Potovsky said.
