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Supreme Court clears the way for Republican-friendly Texas voting maps; In Twin Cities, riverfront development rules get on the same page; Boston College Prison Education Program expands to women's facility; NYS bill requires timely state reimbursement to nonprofits; Share Oregon holiday spirit by donating blood.

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Trump escalates rhetoric toward Somali Americans as his administration tightens immigration vetting, while Ohio blocks expanded child labor hours and seniors face a Sunday deadline to review Medicare coverage.

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Native American tribes are left out of a new federal Rural Health Transformation Program, cold temperatures are burdening rural residents with higher energy prices and Missouri archivists says documenting queer history in rural communities is critical amid ongoing attacks on LGBTQ+ rights.

Report: WV small business labor force at risk from Medicaid cuts

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Monday, June 30, 2025   

A new report says cuts to Medicaid will weaken the small business workforce nationwide, potentially shrinking local economies in rural states like West Virginia.

While congressional estimates show the new budget would cost millions their Medicaid coverage, researchers at Georgetown University found one third of Medicaid enrollees are small business owners, workers, or family members.

A small business is officially defined as a company with fewer than 100 employees.

Study co-author David Chase - the vice president of policy and advocacy for Small Business Majority - said owners and employees are often in the same boat, when it comes to health coverage.

"It's not an exaggeration to say we would see hundreds of thousands of small businesses shut their doors if the owners lost Medicaid coverage," said Chase. "And in terms of the nearly 21 million employees and their families who are relying on Medicaid, they too need coverage. They would have to consider resigning their position at a small business where they currently work to find a job, probably at a bigger company that provides job-based coverage."

West Virginia opted in to the Medicaid expansion in 2014, and in the years since, the state's Medicaid participation increased 44%, to over 500,000.

Small businesses face higher costs in the private insurance market, and Medicaid fills the gap by providing options outside of traditional employee-sponsored insurance.

Report authors say it often takes time to build a business to the point the owner can draw a salary, and Medicaid provides vital relief.

The childcare sector is mostly made up of small businesses and is seen as particularly vulnerable to Medicaid cuts.

Melissa Colagrosso owns A Place to Grow Children's Center in Oak Hill, and said childcare access serves a critical function in local economies.

"If there's no childcare available, people can't work," said Colagrosso. "So we take out the opportunities for small businesses to grow, because they want to expand, they need to hire new employees, and they can't access them because those employees can't access child care. It also makes employees less reliable."

Colagrosso said child care is difficult to access in her area and her own wait lists are two years long. She said when people attempt to assess child care capacity, they often overlook child care workers.

"I may have capacity for 150 and licensed, but I'm only able to take 80 because I haven't been able to build the workforce to be reliable enough and sustainable enough because we can't offer those benefits," said Colagrosso. "And when those safety nets are taken away, it even more impacts that low-income caregiving staff."

She said over 50% of her current staff are reliant on the Medicaid expansion for health coverage.


Disclosure: Georgetown University Center for Children & Families contributes to our fund for reporting on Children's Issues, Health Issues. If you would like to help support news in the public interest, click here.


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