Key Takeaways
The passage of the “One Big, Beautiful Bill” will result in nearly $1 trillion in Medicaid cuts and an estimated $6.3 billion in cuts in Oklahoma alone.Over half of Oklahoma’s rural hospitals are at risk of closing, despite the fact that nearly half of Oklahomans live in rural areas.Rural hospitals will need to redefine their mission as a result, as they will not be able to operate as they do now with limited funding.
Nearly half of Oklahoma’s four million residents live in rural areas. And now, over half of Oklahoma’s rural hospitals are at risk of closing.
The passage of the “One Big, Beautiful Bill” will result in nearly $1 trillion in cuts to Medicaid, and an estimated $6.3 billion in cuts in just Oklahoma, according to state health care leaders. Over a quarter of the population of Oklahoma is enrolled in the state’s Medicaid program, SoonerCare, and more than half of those enrollees are children.
Oklahoma’s situation highlights the barriers rural residents across the country will face in the wake of Medicaid cuts.
Oklahoma Will Be Hit Hard
Medicaid helps fund many rural hospitals and other health facilities in the U.S., among other things.
Over 700 rural hospitals across the country are at risk of closure, with 300 considered to be at “immediate risk” of closure. Oklahoma is one of the top three states likely to bear the brunt of these shutdowns, according to the Center for Healthcare Quality and Payment Reform. The fate of 47 of its 90 rural hospitals now hangs in the balance.
Rich Rasmussen, the president and CEO of the Oklahoma Hospital Association, says rural hospitals will have to “redefine what their mission is” when the law is fully phased in, as they won’t have the funding to operate as they are currently.
“What are small communities supposed to do?” Rasmussen said.
Cuts to Medicaid will likely impact Oklahoma’s 39 critical access hospitals (CAHs), Rasmussen said. These hospitals are designated by Centers for Medicare & Medicaid Services to give basic health care access to rural communities and transfer patients with complex needs to larger facilities. They have limited beds and are typically located at least 35 miles from another hospital.
Nursing homes, emergency rooms, clinics, and other health care facilities that serve rural communities will also be disproportionately impacted by these cuts because they rely more on Medicaid reimbursements to operate than urban hospitals do, according to health care think tank KFF.
Specific health sectors could also struggle. Oklahoma has one of the largest maternity deserts in the country, and obstetrics care could be severely depleted in the 15 most northwestern counties in the state. This could force patients to drive further for routine care, and 80 miles or more for specialty care.
Cuts Are Already Happening
Cuts to care in Oklahoma facilities were already underway before the bill passed.
Endocrinology, rheumatology, pediatrics, wound care, and primary care clinics all ceased operations in July due to cuts made by a regional health system based in Norman, Okla. Although many of these shuttered clinics aren’t in rural areas, they served patients throughout the state, and more are expected to close down the pipeline due to Medicaid cuts.
The state already ranks 47th nationally in overall health performance, and continued cuts will only make things worse, according to Rasmussen.
“It will no longer be safe for many people to live in rural communities if they don’t have ready access to health care,” Rasmussen said. “As a result, people are going to rethink where they live and where they retire.”