Medicaid cuts could drive Michigan hospitals closer to insolvency

Yahoo

27-05-2025

The critical access hospital in Ontonagon, just 50 miles from my hometown in the Upper Peninsula, closed last year.
The nearest emergency room is now a 45-mile drive away — nearly an hour in good weather. In a February snowstorm, that delay can mean the difference between life and death.
Most people hope never to visit an emergency room. But US. Centers for Disease Control and Prevention data shows that nearly 140 million Americans annually utilize ER care — often during the most vulnerable moments of their lives. It's often taken for granted that emergency rooms will always be there for us, but that assumption is increasingly at risk.
I'm an emergency room doctor, and I can tell you firsthand that ERs are the backbone of our country's health care safety net. If HR 1 becomes law, based on a report from the Congressional Budget Office, we can expect millions to lose their Medicaid coverage. This will add to the rolls of the uninsured, placing a larger burden on already stressed hospitals and emergency departments. This means that more hospitals will likely close.
Six hospitals in Michigan are at imminent risk of closure, a recent study by the Centers for Healthcare Quality and Payment Reform found, while 14 more are at risk of closure over time. That's before any impact of these proposed cuts which the passed the U.S. House of Representatives by a single vote, largely along party lines.
Hospitals already operate on razor-thin margins, and anything that disrupts the funding makes those margins even tighter.
Losing billions in Medicaid funding could push many hospitals over the edge.
In Michigan, the numbers are stark: one in five adult residents rely on Medicaid for health care.
Among children, that number increases to two out of every five. Medicaid also covers 38% of all births in the state. Medicaid isn't a fringe benefit for the few — it's a critical lifeline for millions.
And it's a key part of the financial foundation for hospitals that serve our most at-risk communities.
But that foundation is crumbling.
A recent report by the RAND Corporation confirms what frontline physicians already know: America's emergency care system is in crisis, and emergency rooms throughout the country are strained to, or even beyond, their breaking point.
Declining Medicare reimbursements, shrinking insurance payments and threats to Medicaid funding are converging to further endanger access to emergency care.
Currently, 20% of the care provided by emergency rooms in the U.S. is uncompensated, comprising an annual price tag of over $5 billion. This is unsustainable.
With further cuts to Medicaid, it is possible that 22 Michigan communities could soon be left without a hospital — and without the lifesaving emergency care we all depend on.
And it's not just patients on Medicaid who stand to lose. When hospitals close, everyone suffers — whether they're covered by private insurance, Medicare or Medicaid. The collapse of emergency infrastructure in any region puts pressure on surrounding hospitals, increases wait times and reduces the overall capacity of our system to respond in times of crisis.
Emergency physicians like myself are proud to care for anyone who walks through our doors — 24 hours a day, 7 days a week, 365 days a year. We are required by federal law to treat all comers, regardless of their ability to pay.
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But we cannot do it alone. We rely on functioning hospitals, adequate funding and a health care system that values access for all.
If we continue to underfund Medicaid — or treat it as expendable — we risk eroding the structure that holds our emergency care system together.
This isn't just a policy debate. It's a matter of access to health care. It can become a matter of life and death.
Now is the time to ensure the viability of the emergency medical system in our state. We should take steps to protect and strengthen the programs that support emergency care — not dismantle them. When your life is on the line, you shouldn't have to wonder whether help will be there when you need it.
Tell your members of Congress not to cut Medicaid, so we can protect the health care safety net in our state, for our friends and neighbors, for our hospitals and for the safety net that protects all of our residents.
Brad J. Uren is an emergency room doctor, a past president of the Michigan College of Emergency Physicians and vice chair of the board of directors of the Michigan State Medical Society. Submit a letter to the editor at freep.com/letters, and we may publish it online and in print.
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This article originally appeared on Detroit Free Press: Trump Medicaid cuts could close 20 Michigan rural hospitals | Opinion