'Big Beautiful Bill' could cost Georgia rural hospitals $540M, says report

President Donald Trump’s spending bill’s cuts to government-subsidized health insurance could send struggling rural Georgia hospitals into distress or bankruptcy, according to research released by its critics.

A study commissioned by the American Hospital Association found that Georgia rural hospitals could lose $540 million over the 10 years of the bill’s run. Another by the Sheps Center at the University of North Carolina, based on the version of the bill that passed the House in May, listed hundreds of U.S. hospitals “at risk” of closing services or shutting down altogether in the face of Medicaid and other health cuts, including four in Georgia. The Senate is considering deeper cuts.

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The UNC analysis was requested by Democratic leaders in the House and Senate.

“Slashing Medicaid funding is not just a numbers game — it is an action that will rip health care access from communities across America, disproportionately harming low-income individuals, rural populations, and hardworking Americans who rely on Medicaid for access to lifesaving care,” said a statement from America’s Essential Hospitals, a group representing safety-net hospitals.

The Georgia Hospital Association has raised similar concerns, writing to lawmakers that “the bill would devastate rural health care in Georgia” and limit lifesaving services for many families.

Trump has called the spending package “One Big, Beautiful Bill” and it is now officially named that.

Critics made their case against the changes during a news conference Friday afternoon.

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Dr. Mattie Wolf, a neonatologist in Atlanta, treats newborn babies with severe health problems. Medicaid covers nearly half of all births in Georgia, and Wolf told reporters that her patients’ lives and their moms’ health would be endangered by cuts.

“Many of my patients require anywhere from 20 to 30 follow-up visits with pediatricians and subspecialists to continue their recovery, and many require several expensive medications during their first year of life,” Wolf said. ERs have to see all patients, but no law says specialists have to give an appointment to a patient who can’t pay.

Credit: arvin.temkar@ajc.com

Credit: arvin.temkar@ajc.com

Trump and allies in Congress say they want to eliminate “fraud, waste and abuse” in programs such as Medicaid and the Affordable Care Act. One main savings tool with Medicaid would be to remove people from coverage.

The president has said by scaling back Medicaid and other health funding, they are saving it for the future, not hurting it.

“We’re not doing any cutting of anything meaningful,” Trump told reporters recently. “The only thing we’re cutting is waste, fraud and abuse. With Medicaid — waste, fraud and abuse. There’s tremendous waste, fraud and abuse.”

Credit: AP

Most of Georgia’s insurance coverage loss would be among people who get coverage on the Affordable Care Act exchange, or Georgia Access, but about 56,000 Georgians would lose Medicaid coverage and remain uninsured, according to a forecast by the health research nonprofit KFF. The total number of Georgians who could lose all insurance under the bill is about 310,000, according to KFF.

Monty Veazey, a lobbyist for Georgia community hospitals, said, “We need actions. And not a lot of talk. You just can’t sit back and let them whack your budget to where you can’t survive. Somebody’s got to step up.”

There will be increased paperwork requirements for everybody, and smaller grace periods for filing paperwork regularly and for retroactive coverage after the system finally greenlights a patient’s policy. Several analyses say that’s expected to result in coverage losses in Georgia, where the Medicaid computer system known as Gateway is already glitchy and known to mistakenly deny coverage.

Another complicated savings tool in the bill is to freeze a type of Medicaid fund that facilities like hospitals have used to increase their funding. Conservatives say the fund was never meant to be used as a Medicaid cash cow. Hospitals say everyone knows it’s now used to increase Medicaid revenues because states pay hospitals and other facilities so little for serving Medicaid patients compared to other types of insurance.

Of the four hospitals listed as “at risk” in Georgia, three sit in districts served by Republican congressmen who voted for the bill. The AJC reached out to Rep. Austin Scott, whose district includes one of them, Irwin County Hospital in Ocilla. Irwin County Hospital met extra criteria to be on the national list: both running a loss three years in a row, and having a patient base heavily dependent on Medicaid.

Credit: TNS

After Scott helped pass the bill through the House, he praised its tax cuts, its agriculture industry protections, and a provision about wounded veterans. He did not mention Medicaid or other health cuts.

Asked about the risks to Medicaid coverage and the hospital, Scott did not respond to email and telephone messages from the AJC.

Rep. Nikema Williams of Georgia headlined the news conference where Dr. Wolf spoke Friday, saying the bill would “shutter our hospitals.”

The minority whip in the U.S. House, Rep. Katherine Clark of Massachusetts, traveled to Atlanta to join her. Clark noted that in spite of all the cuts in the bill, it still doesn’t break even, but would further raise the national debt by more than $2 trillion, more under the Senate version.

“The additional kicker on it all is that then $3 trillion will go on our country’s credit card for our children and grandchildren to have to pay off, further endangering our economy,” Clark said.

Credit: PHOTO by Ariel Hart

FOUR GEORGIA HOSPITALS AT RISK

At the request of Democratic leaders in Congress, researchers assembled a list of hospital in the U.S. at risk of closing services or closing altogether in response to Medicaid cuts. There were hundreds nationwide and four in Georgia.