ALPENA — President Donald Trump’s “One Big Beautiful Bill Act” is currently waiting for the Senate vote and has garnered concerns from both sides of the aisle, especially regarding Medicaid.

Many are concerned about what the future will hold for Medicaid beneficiaries. Dee Berry, president of the Michigan Association of Nurse Anesthetists, explained that she is most concerned regarding the long-term effects of proposed Medicaid cuts.

“I think right now there’s a lot of fear because we don’t know,” Berry said. “We just don’t know how these cuts are going to be and how they’re gonna affect us down the line and I’m sure that there could be a huge trickle-down effect.”

Berry said that she is also concerned about the number of patients that could potentially be affected by Medicaid cuts.

“Some of the numbers that we’re hearing is up to 750, 000 Michigan residents could be affected by these cuts with a large majority of them being either elderly, disabled, or children,” Berry said, adding that “40% of children in our state are covered under some form of Medicaid coverage.”

Further, Berry expressed concern over the cost of the Medicaid cuts, explaining that rural hospitals might close since many rely on Medicaid reimbursements.

Berry said Medicaid cuts, “Could cause our nation to lose $20 billion over 10 years,” Berry said. “The trickle-down effect … Medicare support on maternity and long-term care. Cancer, mental illness, nursing homes … so this isn’t just going to affect those who get Medicaid coverage … what this may do is potentially close some rural hospitals that many Michiganders depend on.”

A debated topic within the One Big Beautiful Bill Act is Medicaid adjustments including work requirements to qualify.

According to the Michigan Department of Health and Human Services (MDHHS) Executive Directive 2025-3, in 2018 the Centers for Medicare and Medicaid (CMS) issued new guidelines and guidance as to how states should implement work requirements. Further, the Executive Directive explains that Governor Rick Snyder signed Public Act 208 requiring MDHHS to submit a waiver to CMS that would require beneficiaries to comply with work requirements to maintain coverage. MDHHS states that those affected by the 2018 proposed work requirements included “Able-bodied recipients, 19 to 62 years of age, regardless of income level or time enrolled in the program.”

However, following a DC judge’s ruling, MDHHS was no longer allowed to implement work requirements, according to a MDHHS press release from Sept. 2021.

The current One Big Beautiful Bill Act’s proposed work requirements require individuals, as part of the Medicaid expansion population, to complete community service, work, or engage in other qualifying activities to maintain coverage. The bill states that these requirements will go into effect in 2029.

In their Executive Directive, the MDHHS reports that 49% of Medicaid enrollees are employed and 10% are students or homemakers.

Berry stated that she hopes that the work requirements the Trump administration wishes to implement are “reasonable” and are within a context that protects vulnerable people.

“I think we can all agree that Medicaid is not something that was supposed to be a way of life,” Berry said. “It’s supposed to be a stepping zone … I think the intention is that those of us that are able to work and provide start stepping up to do so. If they choose not then they’re going to lose their medical coverage and then obviously they won’t have any medical coverage and then if they do require medical care, surgical care, etc. obviously that’s going to affect them and the communities that they live in and maybe statewide.”

In U.S. Congressman Jack Bergman’s (R-Watermeet) district, as of 2024, 184,245 individuals were enrolled in Medicaid, according to the MDHHS Executive Directive. For the 2023 FY Budget, this resulted in an expense of approximately $2.3 billion, out of $25.4 billion expense for the state.

Bergman told The Alpena News that Americans who need the coverage will continue to receive Medicaid.

“In the countless hours we’ve spent on the Budget Committee discussing the reconciliation process, not once has there been any proposal to cut Medicaid for those it was designed to serve — low-income families, seniors, pregnant moms, or people with disabilities,” Bergman said. “Their coverage stays. What we are doing is adding some common-sense accountability that (is) modeled on successful state programs: if you’re an able-bodied adult with no kids at home, you should work or train to keep getting benefits, with fair exemptions for those who genuinely can’t. That keeps the safety net strong for those who need it, trims waste and fraud, and shows respect for every taxpayer’s hard-earned dollar.”

Kayla Wikaryasz can be reached at 989-358-5688 or kwikaryasz@TheAlpenaNews.com.