Medicaid cuts threaten health care access in Boundary County
Kaniksu Community Health, the only federally qualified health clinic in Boundary and Bonner counties, is in jeopardy of losing millions of dollars due to new federal cuts to Medicaid.
BONNERS FERRY — Rural communities in North Idaho could face significant reductions in access to health care in the coming years as the region’s clinics and hospitals brace for major financial losses tied to upcoming changes in Medicaid.
On July 4, Congress passed the “One Big Beautiful Bill,” a sweeping federal package that includes more than $1 trillion in cuts to Medicaid over the next decade. The law introduces new work requirements, higher copayments, and more frequent eligibility checks, which are expected to result in nearly five million Americans losing coverage, according to GovFacts.org. Yale and University of Pennsylvania scientists calculated these cuts could cause 42,500 avoidable deaths each year.
In rural North Idaho, the impact could be severe. Thousands of residents who rely on Medicaid are now at risk of losing their insurance, said Kevin Knepper, CEO of Kaniksu Community Health, a nonprofit provider with clinics in Priest River, Sandpoint, and Bonners Ferry.
“I don't think anybody in the health care profession will tell you it’s a good thing for healthcare,” Knepper said. “I think it’s going to be disastrous for Bonner and Boundary counties.”
In the two northernmost Idaho counties, Kaniksu Community Health is the only federally qualified health clinic, meaning it receives federal grant funding and enhanced reimbursement from Medicaid and Medicare, as well as other benefits.
The health center currently serves nearly 14,000 patients, more than two-thirds of whom are classified as low income.
“We take care of more Medicaid patients than anyone in North Idaho by far,” Knepper said.
But about 15% of Kaniksu patients are in danger of losing coverage due to the Medicaid overhaul — changes that could cost the clinics millions of dollars and lead to cuts in services.
“Our mandate is that we care for you, no matter your ability to pay,” Knepper said. “So when the patients become uninsured, they still continue to access care. Our financial situation deteriorates, and we have to reduce access, either by reducing the number of people who provide care or by shutting down facilities. That circles back and hurts the patients. It’s a downward spiral. To keep your boat afloat, you have to somehow limit access.”
Similarly, Knepper said Boundary Community Hospital and Bonner General Health will not be able to absorb the added cost of treating uninsured patients.
“I think Bonner General and Boundary are in a lot of trouble. That's just my opinion, but I think both of those CEOs would agree. Bonner and Boundary hospitals will be struggling,” he said.
Helping at-risk patients keep Medicaid coverage
With stricter eligibility checks and new work requirements set to take effect, Kaniksu Community Health is ramping up efforts to help eligible patients retain their Medicaid coverage.
“It’s mutually beneficial — for both us and our patients — that they stay on Medicaid,” Knepper said. “The Medicaid population is already challenged trying to make life work. The system is intentionally designed with so many compliance complexities that it pushes people off coverage.”
To counter this, Kaniksu is prioritizing patient education and support. The clinic is investing in outreach and enrollment teams that will proactively contact Medicaid patients and invite them in to help complete the necessary paperwork for upcoming eligibility checks.
Knepper said the effort could assist thousands of patients who might otherwise fall through the cracks.
“We’re going to be proactive and help our people — our patients — who fit that bill, and make sure they continue to qualify,” he said.
