GOP Health Cuts Threaten Rural Hospital Survival \ Newslooks \ Washington DC \ Mary Sidiqi \ Evening Edition \ Congressional Republicans face backlash over deep healthcare cuts in President Trump’s sweeping economic bill. Proposed reductions to Medicaid and provider taxes could imperil rural hospitals and leave millions uninsured. Lawmakers now weigh a rural hospital fund amid rising opposition.
Quick Looks
- Deep cuts to Medicaid risk coverage for 10.9 million Americans.
- Senate GOP proposes deeper healthcare reductions than the House.
- Provider tax changes may cripple rural hospitals nationwide.
- Lawmakers propose a rural hospital fund amid backlash.
- Debate stalls Trump’s bill ahead of July 4 deadline.
Deep Look
President Donald Trump’s ambitious legislative push for a sweeping economic bill has hit a major obstacle: how to slash billions from health care programs—primarily Medicaid—without devastating coverage for millions or bankrupting the hospitals that serve them. The internal Republican battle now centers on the depth of cuts and their impact, especially in rural America.
The House version of the bill, already passed, would result in 10.9 million more uninsured Americans. The Senate version proposes even deeper Medicaid cuts—sparking alarm within GOP ranks. Senator Susan Collins (R-ME) openly criticized the Senate’s approach, warning, “The Senate cuts in Medicaid are far deeper than the House cuts, and I think that’s problematic.”
Behind closed doors, senators and Trump administration officials are scrambling to finalize the legislation before the president’s self-imposed July 4 deadline. While components such as tax relief and border security funding are mostly agreed upon, healthcare remains the most contentious and unresolved piece.
This legislative moment mirrors the 2017 debacle, when Republicans failed to repeal and replace the Affordable Care Act. Then-Senator John McCain’s famous “thumbs down” vote killed the bill and split the GOP. Senate Majority Leader John Thune is now determined to avoid a repeat, insisting, “This is a good bill and it’s going to be great for our country.”
The bill’s fiscal strategy relies heavily on cuts to healthcare, particularly Medicaid, to balance the cost of tax cuts. Medicaid has expanded significantly since the ACA’s passage, now covering roughly 80 million Americans. Republicans argue this scope is unsustainable and want to revert Medicaid to a program focused on low-income women and children.
Democrats are vehemently opposed. House Democratic Leader Hakeem Jeffries accused Republicans of “trying to take away healthcare from tens of millions of Americans,” dubbing the proposal “a big, ugly bill.”
One major cost-saving measure involves imposing new 80-hour monthly work requirements on Medicaid recipients—despite the fact that most already work. More controversial is the Senate’s proposed rollback of the “provider tax”—a levy nearly every state imposes on hospitals and care providers to draw more federal Medicaid funds.
Senator Josh Hawley (R-MO) and others are worried about the potential for rural hospitals to collapse under the proposed changes. “That’ll depend if we land the plane on rural hospitals,” he said.
States use provider taxes as a funding mechanism—one critics describe as fiscal “laundering,” but which remains vital to Medicaid financing in all states except Alaska. The House bill would freeze the tax at current levels, while the Senate’s version seeks to reduce it further.
Senator Roger Marshall (R-KS) acknowledged the dependence, saying, “I know the states are addicted to it,” but insisted “the provider tax needs to go away.”
Hospitals and healthcare providers strongly oppose the move. The American Hospital Association warned it could overload emergency rooms and force many rural hospitals to shut down. “Some hospitals, especially those in rural communities, may be forced to close altogether,” said AHA President Rick Pollack.
The Catholic Health Association echoed the concerns, stressing that Medicaid insures one in five Americans and nearly half of all children. “The proposed changes to Medicaid would have devastating consequences,” said Sister Mary Haddad, president and CEO, especially for “small towns and rural communities.”
To address the fallout, GOP senators are weighing a new rural hospital fund. A $15 billion fund has been circulated, but lawmakers remain divided—some calling it too small, others too large. Senator Collins has proposed boosting the fund to $100 billion.
“There will be a fund,” confirmed Senator Thune, though he indicated it won’t reach Collins’ suggested size. Hawley is cautiously supportive but remains concerned about execution: “Who will get it to hospitals? Or is this just going to be something that exists on paper?”
Further controversy surrounds a $35 co-pay per medical service for Medicaid patients, included in both House and Senate drafts.
Meanwhile, the financial implications of the bill remain contested. The White House Council of Economic Advisers projects up to $2.3 trillion in deficit reduction over 10 years. However, the nonpartisan Congressional Budget Office’s dynamic score warns the bill could actually increase deficits by $2.8 trillion over the same period.
As Republican lawmakers struggle to finalize details, the healthcare debate remains the largest roadblock in passing Trump’s centerpiece legislation. With millions of lives and vital healthcare institutions at stake, the outcome of these deliberations could redefine the country’s health and economic policy for years to come.
GOP Health Cuts GOP Health Cuts
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