GOP Wrecking Ball Slams Through Medical System

GOP Wrecking Ball Slams Through Medical System

Hospitals are shutting down, slashing programs, and laying off staff. And the worst parts of the spending law haven’t even hit yet.

https://prospect.org/health/2025-07-15-gop-wrecking-ball-slams-through-medical-system/

by Whitney Curry Wimbish July 15, 2025

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Hospitals are closing or actively considering doing so, cutting programs, and laying off staff. Planned Parenthood is warning patients it can no longer accept Medicaid insurance and in one region says it can’t provide services to Medicaid recipients at all, even if the patient doesn’t use Medicaid to pay. And lawmakers in at least five states are planning special sessions to revamp their already-enacted budgets and determine how to handle the cuts, including what cuts they should enact and how to administer the new Medicaid work requirement.

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“There is a sense that the effective dates are pushed out quite a bit, but that’s actually not true. There are a variety of cuts that take effect immediately,” said Edwin Park, research professor at Georgetown University McCourt School of Public Policy.

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FIVE CONSEQUENTIAL PROVISIONS OF THE SPENDING BILL took immediate effect when President Trump signed the mega-bill into law July 4, four of which account for more than $340 billion in slashed funding over the next decade, according to the bipartisan Congressional Budget Office.

The legislation immediately forced most states to cap newly initiated state-directed payments (SDPs), which had been a way for states to raise the low rates of Medicaid closer to those of private insurance. Now, the 40 states that expanded their Medicaid programs under the Affordable Care Act and Washington, D.C., can only charge rates equal to Medicare, which is less generous than what insurance payers pay. Non-expansion states must cap the payments at 110 percent of Medicare rates. The CBO expects the change to eventually strip away almost $150 billion.........................