A new federal law, the One Big Beautiful Bill Act, includes cuts to the joint federal-state health insurance program for poor and disabled. It also implements work requirements for people who receive Medicaid.

But what exactly those changes will mean locally remains unknown, as a group of local health care administrators told an audience of about 50 people Wednesday evening at Iowa Central Community College.

Asked about multiple things that could happen, a panel of representatives from the Webster County Health Department, UnityPoint Health ­ Fort Dodge, Friendship Haven, UnityPoint ­ Berryhill Center, Golden Day Adult Day and the Community Health Center of Fort Dodge could only respond that they did not know the answers.

“We don’t know yet what is going to happen,” said Kari Jones, chief nursing officer for UnityPoint Health ­ Fort Dodge.

Jennifer Pullen, executive director of the UnityPoint ­ Berryhill Center, said that regardless of what happens, local health care providers will be working together for the Fort Dodge community.

“For our agencies that are represented at the table and even those that are not represented, I feel very strongly that we work very well together,” she said. “We are all here working together for the community.”

All of the entities represented Wednesday night see a high percentage of patients who rely on Medicaid to pay their health care bills.

At the Community Health Center, more than 50 percent of the patients are on Medicaid, according to Renae Kruckenberg, the center’s chief executive officer. She added that among the center’s dental patients that figure is even higher, at about 80 percent.

At the Berryhill Center, a behavioral health facility, about 52 percent of the patients are on Medicaid, Pullen said.

“Pretty much everyone we see is Medicaid or is uninsured,” said Sara Carspecken, maternal health director for the Webster County Health Department.

In Friendship Haven’s Simpson Health Care Center and its Journeys program, about 50 percent of the people are on Medicaid, according to Kalleen Engels, the retirement community’s chief operations and financial officer. She added that percentage may be lower than that found in other Iowa nursing homes.

Asked what programs may be at risk if there are sharp cuts in Medicaid, Pullen said peripheral services will be the first to be impacted. She said those services include case management in which a Berryhill staffer helps patients keep track of all their medication needs and appointments. Those services will also include transportation, which is sometimes provided by Berryhill staffers.

Panelists were also asked about complaints of waste, fraud and abuse in Medicaid.

“I don’t think anybody up here is getting overly paid by Medicaid,” Kruckenberg replied.

Whatever Medicaid cuts happen will hit as Iowa experiences severe shortfalls in women’s health care, according to Carspecken.

She said Iowa has one of the worst shortages in obstetricians/gynecologists in the nation. She added that most women in rural Iowa have to travel an hour or more for obstetrics care.

“There really needs to be an alarm sounding in Iowa on women’s health care and maternal health care,” she said.