Ohio Hospital Association praises senators, won’t say if their vote cost hospitals billions

The Ohio Hospital Association was quick to praise the state’s Republican U.S. senators for a provision in President Donald Trump’s One Big Beautiful Bill Act. But it won’t say whether overall, the legislation will save or cost its member hospitals money.

Meanwhile, outside experts say rural and urban hospitals will lose billions.

Signed on July 4, the law gives an estimated $1 trillion in tax cuts to the richest 1% of Americans over 10 years and adds $3.4 trillion to the deficit.

Those deficits would be even higher if the new law didn’t slash more than $1 trillion from Medicaid.

Between that and cuts to people using the Affordable Care Act’s insurance exchanges, the non-partisan Congressional Budget Office estimates that 10 million more Americans will be uninsured by 2034 because of the law passed by congressional Republicans and signed by Trump.

In Ohio, 440,000 stand to lose insurance.

The Ohio Hospital Association in May told the legislature that half of Ohio hospitals and 72% of rural hospitals have reported operating losses since 2022.

Emergency departments in all U.S. hospitals have to treat people regardless of their ability to pay. Ohio’s emergency doctors warn that having to treat a big new wave of uninsured patients will increase wait times and force hospitals to cut staff.

But Ohio’s hospitals and their industry group declined to fight the legislation or condemn the state’s representatives in Washington, D.C. who supported it.

Instead, four rural hospital chains praised Republican U.S. Sens. Jon Husted and Bernie Moreno for their vote.

“Your leadership and advocacy made a clear difference in steering vital funding toward the facilities that are the backbone of healthcare in our part of the state,” top executives with Memorial Health, Genesis Healthcare, Adena Health, and Southern Ohio Medical Center said in a letter. “Thanks to your efforts, our hospitals will be able to continue providing high-quality care close to home, keep essential services running, and sustain thousands of local jobs—for years to come.”

They were praising Moreno and Husted because they supported a measure that provides $50 billion mostly for rural hospitals over the next five years. The federal government still has to determine how a big portion of that money will be doled out. And health-policy experts at KFF say that a good portion of that money could end up at urban and suburban facilities.

But the Ohio senators and the hospital chains praising them said that the provision would give Ohio’s rural hospitals $1.3 billion over five years.

The Ohio Hospital Association joined in the praise.

“The Ohio Hospital Association is extremely grateful for the provisions in the One Big Beautiful Bill Act that establish new financial resources for rural hospitals and extends Ohio’s Medicaid supplemental payment program through 2028,” spokesman John Palmer said in an email. “We are grateful for the opportunity to discuss these critical issues with our congressional delegation and look forward to continued collaboration on future health care policies.”

Even if Ohio’s rural hospitals are getting the full $1.3 billion the senators say, at least two prominent groups say Ohio hospitals still will lose billions under the One Big Beautiful Bill Act.

In a fact sheet, the American Hospital Association said that over 10 years, Ohio’s rural hospitals will lose $2.5 billion in Medicaid funding. That’s nearly double the amount Husted and Moreno said they were able to add back in, and most of those cuts won’t hit until after the supplement Husted and Moreno supported dries up, KFF said.

Potentially adding to hospital woes is that the bill supported by the Ohio senators will cost 18,000 rural Ohioans their health insurance, according to the American Hospital Association.

Because Ohio has a relatively large rural population with a high preponderance of Medicaid patients, it will be particularly hard hit by the Trump Medicaid cuts, KFF said in a July 2 analysis. It said Ohio would lose $6.45 billion in rural Medicaid spending over 10 years — the sixth most of any state.

That amount dwarfs the $1.3 billion Husted and Moreno say they won for rural hospitals. But Matthew Perry, president and CEO of Genesis Healthcare System in Zaneville, said that the One Big Beautiful Bill Act allows Ohio to leverage more federal dollars through a provider tax.

“… it also included a $50B five year fund to directly support rural hospitals, of which Ohio rural hospitals will receive our fair share,” he said in an email. “It is true that the (One Big Beautiful Bill Act) does include reductions in the total amount of provider taxes that states can use to receive federal matching Medicaid funds beginning in 2028, but this goes down gradually over time and bottoms out even a little higher than where Ohio hospitals are today. So, no, over ten years, Senators Moreno and Husted actually enabled rural Ohio hospitals to receive significantly higher Medicaid funding than we are receiving today.”

Leaders of Memorial Health, Adena Health, and Southern Ohio Medical Center — the other systems that praised Husted and Moreno — didn’t respond to questions for this story.

Last week, KFF released an analysis of the $50 billion rural health supplement that made it difficult to see how Ohio’s rural hospitals could be coming out ahead in the One Big Beautiful Bill Act. For one thing, it takes away twice as much as it adds, it said.

“The rural health fund includes $50 billion, which is about one-third of the estimated loss of federal Medicaid funding in rural areas,” it said.

The analysis added that there’s a lot of uncertainty around how the money will be doled out. Half will be distributed under an approach still to be determined by the U.S. Centers for Medicare and Medicaid Services.

And crucially, the $50 billion supplement for rural hospitals is temporary, while the cuts to Medicaid are permanent, the analysis said.

And that doesn’t even consider estimates from the nonpartisan Congressional Budget Office that the Trump law will increase the number of uninsured Americans by 10 million by 2034. Those people won’t stop getting sick and injured, and when they’re ill enough, many will go to an emergency room that has to care for them even if they can’t pay.

Many of those costs will be in addition to the loss of Medicaid funds, the KFF analysis said.

“This does not account for other revenue losses related to the bill, including cuts to federal spending for the (Affordable Care Act) Marketplaces, or the revenue losses stemming from the increased number of people who will be uninsured because of the expiration of the enhanced ACA premium tax credits and the implementation of final Marketplace integrity rules,” it said. “The impact of these changes on rural areas, and the extent to which the rural health fund offsets losses, will vary across the country.”

So were the rural health systems and the Ohio Hospital Association praising Husted in Moreno as the senators took billions away from them? For its part, the hospital association wouldn’t say if it disputed the estimates of KFF and the American Hospital Association. It wouldn’t even say if its members will gain or lose under the One Big Beautiful Bill Act.

“The Ohio Hospital Association is extremely grateful for the provisions in the One Big Beautiful Bill Act that establishes new financial resources for rural hospitals and extends Ohio’s Medicaid supplemental payment program through 2028,” said Palmer, its spokesman. “We are grateful for the opportunity to discuss these critical issues with our congressional delegation and look forward to continued collaboration on future health care policies.”