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‘They're playing politics with people's lives': Trump's big bill would slash Planned Parenthood's Mass. budget in half

‘They're playing politics with people's lives': Trump's big bill would slash Planned Parenthood's Mass. budget in half

Boston Globea day ago
'They're playing politics with people's lives,' said Ireland. 'It saddens me that the legislature does not see the real humans that are being affected by this decision-making.'
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Ireland, a practicing OB/GYN and assistant professor of obstetrics and gynecology at UMass Memorial Medical Center and UMass Chan Medical School in Worcester, said that in just the past several days, she treated three women with widely different medical needs at the league's clinics.
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One had pre-cancer of the cervix. Another had a sexually transmitted disease that she caught from an unfaithful partner. And a third was about to start a pre-med program at an Ivy League school, got pregnant, and wanted an abortion.
'We provide excellent care based on quality and patient satisfaction and I hate to see that threatened,' Ireland said.
The league has four clinics in Boston, Marlborough, Springfield, and Worcester, although abortions are not performed at the one in Marlborough. The clinics provide services such as birth control, Pap smears, breast exams and abortions.
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The league provided 9,462 abortions last year, and more than half of them were achieved using a combination of two medications, mifepristone and misoprostol.
Federal law, specifically the 1977 Hyde Amendment, already bans states from using federal Medicaid dollars to pay for abortions. Massachusetts, like more than a dozen mostly blue states, uses its own funds to cover abortions for Medicaid recipients. The legislation that President Trump and Republicans in Congress are pushing would affect federal money that covers other medical services and helps keep clinics running.
Michael King, president of the Massachusetts Family Institute, an anti-abortion rights group,
said there are 'plenty of other clinics that can address those needs' in Massachusetts if Congress approves the Medicaid cuts.
He noted that Planned Parenthood said it performed 402,000 abortions nationwide in its 2023-24 annual report, which King called a record number.
He also cited a recent study by the Washington-based Ethics and Public Policy Center, a think tank that says it applies 'the riches of the Jewish and Christian traditions' to law, culture, and politics. The study found that 11 percent of women who had medication abortions experienced serious adverse complications.
This rate, which has been cited by Republican members of Congress, was significantly higher than the less than 0.5 percent rate found in clinical trials by the US Food and Drug Administration.
'If Planned Parenthood clinics closing means that the number of abortions declined, then we are very pleased that the lives of more babies will be saved in Massachusetts,' King said.
Critics of the Medicaid cuts, however, said congressional Republicans are using the so-called 'Big Beautiful Bill' to knee-cap an organization that they have long opposed.
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Although Planned Parenthood isn't mentioned in the bill, 'all they needed to add was it rhymes with wood or Hollywood,' said Fabiola De Liban, director of sexual and reproductive health at the National Health Law Program, in Los Angeles.
Ireland said that if the House approves the bill containing the Medicaid cuts, the Planned Parenthood League of Massachusetts is committed to keeping the doors of all four clinics open and maintaining services.
She said the league might seek to provide other services to bolster income, including vasectomies and treatment for perimenopause, the physical and emotional symptoms that often appear as a woman approaches menopause. Perimenopausal care includes hormone therapy, vaginal creams, and certain medications that can help manage symptoms like hot flashes and mood changes.
Jonathan Saltzman can be reached at
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Rural hospitals brace for financial hits or even closure under Republicans' $1 trillion Medicaid cut
Rural hospitals brace for financial hits or even closure under Republicans' $1 trillion Medicaid cut

Los Angeles Times

timean hour ago

  • Los Angeles Times

Rural hospitals brace for financial hits or even closure under Republicans' $1 trillion Medicaid cut

OMAHA, Neb. — Tyler Sherman, a nurse at a rural Nebraska hospital, is used to the area's aging farmers delaying care until they end up in his emergency room. Now, with the Trump administration planning around $1 trillion in Medicaid cuts over 10 years, he fears those farmers and the more than 3,000 residents of Webster County could lose not just the ER, but also the clinic and nursing home tied to the hospital. 'Our budget is pretty heavily reliant on the Medicaid reimbursement, so if we do see a cut of that, it'll be difficult to keep the doors open,' said Sherman, who works at Webster County Community Hospital in the small Nebraska town of Red Cloud just north of the Kansas border. If those facilities close, many locals would see their five-minute trip to Webster County hospital turn into a nearly hour-long ride to the nearest hospital offering the same services. 'That's a long way for an emergency,' Sherman said. 'Some won't make it.' States and rural health advocacy groups warn that cutting Medicaid — a program serving millions of low-income and disabled Americans — would hit already fragile rural hospitals hard and could force hundreds to close, stranding some people in remote areas without nearby emergency care. More than 300 hospitals could be at risk for closure under the 'Big Beautiful Bill Act,' according to an analysis by the Cecil G. Sheps Center at the University of North Carolina at Chapel Hill, which tracks rural hospital closures. Even as Congress haggled over the controversial bill, a health clinic in the southwest Nebraska town of Curtis announced Wednesday it would close in the coming months, in part blaming the anticipated Medicaid cuts. Bruce Shay of Pomfret, Conn., fears he and his wife could be among those left in the lurch. At 70, they're both in good health, he said. But that likely means that if either needs to go to a hospital, 'it's going to be an emergency.' Day Kimball Hospital is nearby in Putnam, but it has faced recent financial challenges. Day Kimball's CEO R. Kyle Kramer acknowledged that the bill passed Thursday — estimated to cut federal Medicaid spending in rural areas by $155 billion over 10 years — would further hurt his facility's bottom line. Roughly 30% of Day Kimball's current patients receive Medicaid benefits, a figure that's even higher for specific, critical services like obstetrics and behavioral health. 'An emergency means I'm 45 minutes to an hour away from the nearest hospital, and that's a problem,' Shay said. And he and his wife wouldn't be the only ones having to make that trip. 'You've got, I'm sure, thousands of people who rely on Day Kimball Hospital. If it closed, thousands of people would have to go to another hospital,' he said. 'That's a huge load to suddenly impose on a hospital system that's probably already stretched thin.' Rural hospitals have long operated on the financial edge, especially in recent years as Medicaid payments have continuously fallen below the actual cost to provide healthcare. More than 20% of Americans live in rural areas, where Medicaid covers 1 in 4 adults, according to the nonprofit KFF, which studies healthcare issues. President Trump's $4.5-trillion tax breaks and spending cuts plan would worsen rural hospitals' struggles by cutting a key federal program that helps states fund Medicaid payments to healthcare providers. To help offset the lost tax revenue, the package includes $1.2 trillion in cuts to Medicaid and other social safety net programs — cuts they insist only root out fraud and waste in the system. But public outcry over Medicaid cuts led Republicans to include a provision that will provide $10 billion annually to buttress rural hospitals over the next five years, or $50 billion in total. Many rural hospital advocates are wary that it won't be enough to cover the shortfall. Carrie Cochran-McClain, chief policy officer with the National Rural Health Assn., said rural hospitals already struggle to break even, citing a recent American Hospital Assn. report that found that hospitals in 2023 got nearly $28 billion less from Medicaid than the actual cost of treating Medicaid patients. 'We see rural hospitals throughout the country really operating on either negative or very small operating margins,' Cochran-McClain said. 'Meaning that any amount of cut to a payer — especially a payer like Medicaid that makes up a significant portion of rural provider funding — is going to be consequential to the rural hospitals' ability to provide certain services or maybe even keep their doors open at the end of the day.' A KFF report shows 36 states losing $1 billion or more over 10 years in Medicaid funding for rural areas under the Republican bill, even with the $50 billion rural fund. No state stands to lose more than Kentucky. The report estimates the Bluegrass State would lose a whopping $12.3 billion — nearly $5 billion more than the next state on the list. That's because the bill ends Kentucky's unique Medicaid reimbursement system and reduces it to Medicare reimbursement levels. Kentucky currently has one of the lowest Medicare reimbursement rates in the country. It also has one of the highest poverty rates, leading to a third of its population being covered by Medicaid. Kentucky Gov. Andy Beshear, a two-term Democrat widely seen as a potential candidate for president in 2028, said the bill would close 35 hospitals in his state and pull healthcare coverage for 200,000 residents. 'Half of Kentucky's kids are covered under Medicaid. They lose their coverage and you are scrambling over that next prescription,' Beshear said during an appearance on MSNBC. 'This is going to impact the life of every single American negatively. It is going to hammer our economy.' Beck and Haigh write for the Associated Press. Haigh reported from Hartford, Conn.

President Trump's "big, beautiful bill" threatens Medicaid access for millions in Florida, advocates warn
President Trump's "big, beautiful bill" threatens Medicaid access for millions in Florida, advocates warn

CBS News

timean hour ago

  • CBS News

President Trump's "big, beautiful bill" threatens Medicaid access for millions in Florida, advocates warn

Millions of Floridians could lose access to life-saving Medicaid coverage under a new legislation that slashes billions of dollars in federal funding, health advocates warn. The Florida Health Justice Project estimates the legislation will cut about $4 billion annually in federal Medicaid support to the state, impacting at least one million current recipients. While it's unclear exactly who will lose coverage, advocates say the most vulnerable populations — including elderly residents who rely on Medicaid to help pay for Medicare premiums and legal immigrants with temporary status — will be among the first affected. "There's really just one step away from sheer panic," said Lynn Hearn of the Florida Health Justice Project. "If you have a person with a severe disability, they are relying upon the services of Medicaid literally to stay alive." In Florida, roughly four million low-income individuals or people with disabilities depend on Medicaid, the government-funded health insurance program. Florida residents with disabilities fear tighter Medicaid restrictions Paolo Linares, a Liberty City resident, is among them. Diagnosed with autism and ADHD, she lives at home but was hoping to gain independence by moving out. She said the new restrictions could make Medicaid inaccessible when she needs it most. "This type of paperwork may make it harder in the case that I may need it," Linares said. "If you're going to put more stricter things on this, what are you going to do to help these people?" Clinics may close as Medicaid cuts ripple through Florida's health system The ripple effects could reach beyond Medicaid recipients. Hearn said as fewer people are able to seek care, medical providers may not be able to stay in business — affecting access for even those who remain insured. "When there aren't as many people who are insured and able to go to the doctor and get services, then those service providers aren't able to maintain their business," she said. "And then they shut down." Among those expected to lose coverage are refugees, asylum seekers, parolees, and others from countries like Afghanistan and Syria who are in the U.S. legally but lack permanent resident status. "These are people who have been able to get coverage for their families, but that will end," Hearn said. She added that the next state budget cycle will likely force Florida to make tough choices about what Medicaid benefits to continue funding. For now, the Florida Health Justice Project said it will focus efforts on lobbying state lawmakers to secure alternative funding for the program.

Diagnosing Medicaid Cuts To Hospitals In The One, Big, Beautiful Bill
Diagnosing Medicaid Cuts To Hospitals In The One, Big, Beautiful Bill

Forbes

time2 hours ago

  • Forbes

Diagnosing Medicaid Cuts To Hospitals In The One, Big, Beautiful Bill

WASHINGTON, DC - JULY 03: U.S. Speaker of the House Mike Johnson (R-LA) shakes hands with Rep. Jodey ... More Arrington (R-TX) alongside fellow House Republicans during an enrollment ceremony for H.R. 1, the One, Big, Beautiful Bill Act at the U.S. Capitol on July 03, 2025 in Washington, DC. The House passed the sweeping tax and spending bill after winning over fiscal hawks and moderate Republicans. The bill makes permanent President Donald Trump's 2017 tax cuts, increase spending on defense and immigration enforcement and temporarily cut taxes on tips, while at the same time cutting funding for Medicaid, food assistance for the poor, clean energy and raises the nation's debit limit by $5 trillion. (Photo by) Since the pandemic struck the U.S., most Americans have developed a keen appreciation of their hospitals and an equal awareness of how fragile these hospital systems really are. Which is why it's critical to understand the role that Medicaid and Medicaid State-directed payments (SDPs) play in the survival of what are known as Safety Net Hospitals. And what's even more important is how the passage of the One Big, Beautiful Bill Act will now affect Medicaid and those SDPs, supporting these hospitals. So what are Safety Net Hospitals and what do they do? As the name implies, these hospitals play a critical role in the U.S. Healthcare system, they are literally the lifeline for vulnerable populations, including those who are uninsured or have Medicaid. They serve as a 'safety net' by offering services regardless of a patient's ability to pay or their insurance status. These hospitals are often located in low-income communities and rural areas. These hospitals also often operate on fragile margins (approximately 39% experience negative margins), and their reserve funds, an indicator of stability, are not comforting. Without adequate reserve funding, a hospital or nursing home is unable to function in the event of a downturn in reimbursements. Inadequate cash reserves, measured in the number of days the facility can continue operating with no or delayed income, portend the collapse or even closure of the operation. What is the financial lifeblood for these hospitals are the aforementioned SDPs, this payment arrangement permit states under 42 CFR 438.6(c) to make supplemental payments to hospitals for Medicaid patients which can amount to even more than Medicare payment coverage. This funding is critical in covering hospital operations and when you consider that the days of cash on hand in 1 in 10 hospitals is less than 110 days, they are literally rated 'Vulnerable' or worse, "Highly Vulnerable." The Rural Health Transformation Program The Act does acknowledge the fragility of rural hospitals and has an initiative called The Rural Health Transformation Program which will appropriate $10 billion per fiscal year to Centers for Medicare & Medicaid Services (CMS) for fiscal years 2026-2030, for a total of $50 billion over five years to help them. But this deficit math simply doesn't add up and even the details of their administration are vague. Adding to the problem, the The Act makes it more difficult for states to close payment shortfalls by restricting their ability to use provider taxes to boost Medicaid payments. This further limits resources for hospitals and increases financial pressure, especially in states that have used these mechanisms to support rural and Safety Net Hospitals. According to Becker's Hospital Review, for the first time in the last decade, the average number of days cash on hand dropped below 200 to 196.8. The upper half of U.S.-based nonprofit acute healthcare providers reported an average of 292 days, while the lower half reported an average of 128 days. Healthcare profession teamwork and doctor service concept - International medical staff group of ... More doctors, nurses and surgeon specialist standing with stethoscopes in the hospital. This is more than a hypothetical forecast. A recent report documents 18 hospital and emergency department closures or forced mergers so far this year. Another study found that several hospitals and health systems are reducing their workforces or jobs amid financial and operational challenges. To cite one example, Columbus (Ind.) Regional Health (CRH) notified the state that it will lay off 50 employees. The layoffs come as the health system plans to close its inpatient rehabilitation unit and the CRH Orthopedics and Sports Medicine outpatient practice, according to a news release dated June 30. Unsurprisingly, the closures negatively affect local healthcare access with broader consequences for the community and its economy. Layoffs and closures, especially in rural or smaller communities, often result in fewer available services, longer waiting times, and, in some cases, the complete loss of essential departments, such as emergency rooms or maternity wards. As a result of these cutbacks, medical care is compromised and everyone suffers. . With fewer staff members, remaining employees face increased workloads and higher stress, which can lead to burnout and a decline in morale. This often translates to longer wait times, rushed patient interactions, and increased risk of medical errors. Under such circumstances, healthcare workers often experience burnout, job insecurity, and increased turnover, all of which exacerbates staffing shortages and negatively impacts patient care. Many hospitals, especially those with negative. Many hospitals, especially those with already negative or low operating margins, may be forced to reduce services, lay off staff, or close altogether. This risk is especially acute for rural hospitals, which often operate on thin margins and heavy reliance on Medicaid funding. Healthcare facility closures, especially in rural areas, have a ripple effect on the communities they once served because hospitals are often among the largest local employers. Workforce reductions decrease household incomes, reduce local consumer spending, and shrinking tax revenues, can jeopardize funding for schools and infrastructure. The multiplier effect means that each healthcare job supports additional jobs in related sectors such as food services, transportation, and construction. Vulnerable populations are disproportionately affected by cutbacks, closures, and mergers of healthcare facilities. Cuts to administrative and support roles impact services for seniors, non-English speakers, and other vulnerable groups, reducing their ability to access care and navigate the health system. In the long term, hospital closures and job cuts can result in a 14% reduction in healthcare-sector employment and may exacerbate ongoing economic decline; again, rural communities are disproportionately affected. These changes can make it harder to recruit healthcare professionals in the future, further eroding local healthcare infrastructure. Why are smaller hospitals and rural hospitals already so vulnerable? The answer is multi-factorial, as they face financial challenges and layoffs due to a combination of structural, economic, and workforce-related factors. And there are no quick fixes that legislation can address. With rural hospitals particularly vulnerable to Medicaid cuts, KFF analyses (formerly known as The Kaiser Family Foundation estimate a $50–$155 billion reduction in federal Medicaid spending for these areas over the next 10 years. KFF projects more than 1.8 million rural residents will lose Medicaid coverage. Many rural hospitals may be forced to choose between maintaining services, retaining staff, or shutting down, which would cause patients to travel long distances for care. Smaller hospitals have significant fixed costs ('keeping the lights on') that do not scale down when they experience lower patient volume, making their cost per patient higher compared to larger hospitals. Larger hospitals benefit from economies of scale, as they spread these costs over a greater number of patients. As noted above, rural and small hospitals typically generate less revenue and have lower occupancy rates, making them more susceptible to financial volatility and downturns. They not only lack the financial reserves but also the diverse service lines that help larger hospitals weather economic shocks. Many small hospitals, especially in rural areas, serve a higher proportion of patients who are covered by Medicaid, Medicare, or who are uninsured. Federal payers reimburse at lower rates, often below the cost of care, resulting in chronic financial losses. Private insurers also tend to pay small hospitals less for the same services compared to larger facilities. What compounds this even more are Medicaid cuts in the new federal budget that are expected to increase uncompensated care. The cuts are projected to increase the number of uninsured Americans by 11.8 million, ballooning uncompensated care. This will strain hospital finances, as more patients will be unable to pay for services. Medicare cuts may be next. If the bill increases the federal deficit as projected, it could trigger approximately $500 billion in mandatory Medicare cuts, potentially resulting in a 4% reduction in payments to hospitals and other providers, unless Congress acts to prevent these cuts. Smaller hospitals face unique workforce challenges as they struggle to attract and retain qualified healthcare professionals. Often, they rely on expensive temporary staff (locums) to fill gaps, which further increases costs. The lack of prestige, professional isolation, and fewer opportunities for advancement make recruitment and retention more difficult compared to larger, urban hospitals. In summary, Medicaid cuts will have unintended consequences. Hospital and health system workforce reductions directly reduce healthcare access and quality for all patients, residents, destabilize local economies, and create a cycle of declining health and economic outcomes, especially in rural and underserved areas. Hospitals with high shares of Medicaid patients, particularly in rural and low-income urban areas, will be the most affected and may face existential threats due to the combined effects of coverage losses, reduced payments, and increased uncompensated care.

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