Pike County judge warns Medicaid reductions could imperil local health services and EMS

Judge Ray Jones said proposed reductions to Medicaid funding and state cuts to aging programs pose an immediate risk to health-care employment and rural emergency services in Eastern Kentucky.

"The growth in health care has been fueled in no question by Medicaid expansion," Jones said, adding that if federal and state funding diminishes, local hospitals, clinics and federally qualified health centers could face staff reductions. He named Tug Valley ARH, McDowell ARH, Our Lady of the Way at Martin, and Pikeville Medical Center when discussing facilities that rely heavily on Medicaid-funded activity.

Jones described conversations with health-care workers and said job losses were a plausible outcome if the funding picture worsens. "I think you'll see people in health care lose their jobs because the money's not going to be there," he said.

He also raised concerns about ambulance services, saying an ambulance-owner contacted him to say reimbursement for Medicaid-covered emergency runs is insufficient to sustain operations. "There's no way that they can pay their employees and keep a business running," Jones said, warning that rural response times and EMS coverage could deteriorate.

Jones read a June 6 letter from the Cabinet for Health and Family Services that described a reduction of $9.1 million in the state fiscal year 2027 allocation for the expanded senior meal program, plus percentage cuts across the Department for Aging and Independent Living affecting caregiver programs, home care, and the long-term care ombudsman. He said the five-county Big Sandy Area Development District could need about $2 million to make up the shortfall for those services.

Jones urged public attention to how cuts would affect access to care in remote areas, noting long ambulance drives and an aging population with more deaths than births in recent years. He framed the concern as both a public-health and a fiscal issue for the county.