Oct. 25—WILKES-BARRE — In Northeast Pennsylvania, Medicaid covers a significant portion of the population.

Approximately 27% of Luzerne County residents are enrolled in Medicaid, as are 24% of Lackawanna County residents and 21% of Wayne County residents.

The Institute’s Health and Health Care Task Force 2026 report that examines Medicaid and community wellness finds that changes in federal law could have significant implications for the health care system.

“Federal Medicaid spending is anticipated to decline by $911 billion over the next decade,” said Jill Avery-Stoss, President and CEO of The Institute. “At the same time, an estimated 310,000 Pennsylvania residents may lose coverage as a result of the changes in the law. Fewer insured patients could translate into more uncompensated care, which puts additional strain on medical providers and hospitals.”

Avery-Stoss said Pennsylvania’s experience with Medicaid expansion illustrates the connection. She said since expansion began in 2015, hospital uncompensated care costs have fallen 27.7%, even as overall health care costs have risen. A reversal in coverage could place renewed financial pressure on both large and small providers who are providing care to uninsured patients.

Avery-Stoss said new federal restrictions will limit some of the tools states have traditionally used to finance Medicaid. States facing slower revenue growth and increased spending needs may respond by adjusting reimbursement rates, eligibility, or benefits.

“Medicaid reimbursement rates are often already lower than payments from private insurers and Medicare,” notes Avery-Stoss. “If rates remain stagnant or decline while the cost of providing care rises, providers may respond by reducing staff or services. Organizations serving large numbers of Medicaid patients, as well as providers in rural areas, are particularly vulnerable to the impact of these changes.”

Avery-Stoss said workforce shortages could compound these concerns, but there are potential resources available to ease some of the pressure. She said the federal Rural Health Transformation Program is intended to support efforts such as recruiting and retaining health care workers, developing new technologies, strengthening partnerships among providers, and helping rural hospitals address financial challenges. However, this funding is temporary and is not expected to fully offset the longer-term effects of changes in Medicaid funding.

“The consequences could ultimately reach beyond Medicaid patients, creating a ripple effect in which coverage losses reduce hospital revenue, potentially contributing to layoffs and service reductions,” Avery-Stoss said. “Reduced access to care can then place additional pressure on communities, employers, and local economies. Rural communities face particularly significant risks.”

For Northeastern Pennsylvania, where Medicaid plays a sizable role in the health care system, Avery-Stoss said the coming changes therefore represent more than an insurance issue.

“How hospitals and providers adapt could help shape the availability of health care throughout the region in the years ahead,” Avery-Stoss said.

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Reach Bill O’Boyle at 570-991-6118 or on Twitter @TLBillOBoyle.