On Tuesday, Senate Republicans narrowly passed President Donald Trump’s Big Beautiful Bill, with a tiebreaker from Vice President JD Vance. Part of the bill aims at cutting $1 trillion from Medicaid, which might have negative impacts on rural health services.
Thunder Bay Community Health Service serves around 19,000 people in northeast Michigan. The health service is similar to many others around the region, helping aid individuals with clinical, dental and optical care.
Sarah Martinson, communication director for Thunder Bay Community Health Service, said that patients may not be able to pay their bills due to losing Medicaid coverage, and that cost would be absorbed by the health center.
“The people will still get care no matter what, but this will put more of a financial burden on community health centers who are already on pretty tight margins to maintain business,” Martinson said.
There are around 35,000 people who are on Medicaid in northern Michigan, according to Martinson and about 2.25 million statewide. If the bill passes through the U.S. House of Representatives again, people would need to reapply for Medicaid every six months instead of every year.
It would also increase the hours an individual would need to work before they are eligible to receive coverage. The Trump Administration has stated that the bill would cut down on “fraud, waste and abuse” within Medicaid, according to a press release.
Another concern for hospitals and health centers is the downsizing of clients. Senior Vice President and Chief Innovation Officer of the Michigan Health and Hospital Association (MHA) Laura Appel said that rural health centers are already facing challenges.
“Rural hospitals operate on much thinner margins, and they have the same degree of fixed cost with fewer people to spread those costs among because their populations are smaller, and in many places, they're actually shrinking,” Appel said. “Financially, I would say that rural hospitals are at greater risk of having to reduce services and at greater risk of the ultimate possibility of closing altogether.”
In a report by the MHA, health care is Michigan's top employer, with around 220,000 people in the workforce.
During the bill’s debate in the Senate, lawmakers added that hospitals could receive financial aid due to the cuts through a $50 billion program that would begin in 2028. Appel said the program won’t offset the damage the bill would cause.
“It's a $1 trillion cut to Medicaid over 10 years, and this is $50 billion to help rural hospitals in 50 states with $10 billion a year,” Appel said. “I think we can all do the math and understand that that's not really going to make up the difference.”
Michigan Sen. Gary Peters (D-Bloomfield Twp.) voted no on the bill and released a statement expressing his concern about cuts to Medicaid, but also to the Supplemental Nutrition Assistance Program (SNAP).
“The bill that Republicans just passed will rip health care away from hundreds of thousands of Michiganders, make it harder for families across the country to afford food and pay their energy bills, and balloon our deficit by trillions of dollars,” Peters wrote. “This bill is reckless, irresponsible, and an unconscionable betrayal of American families.”
The bill will now go back to the House for a final vote.
Congressman Jack Bergman (R-Watersmeet) couldn’t be reached for comment.
This story was produced by the Michigan News Group Internship Program, a collaboration between WCMU Public Media and local newspapers in central and northern Michigan. The program’s mission is to train the next generation of journalists and combat the rise of rural news deserts.
