Hospitals

This analysis estimates that the House-passed reconciliation bill could lead Medicaid spending in rural areas to decrease by $119 billion and a 1.5 million drop in enrollment over 10 years.

The Senate Finance Committee’s reconciliation language would reduce existing state-directed payments to hospitals and nursing facilities over time until they are at or slightly above Medicare rates.  This analysis identifies states that might have to reduce payment rates for hospitals or nursing facilities if the language is passed into law.

If Congress passes the reconciliation bill with the Finance Committee provision, 22 states might have to reduce their provider taxes on either hospitals or managed care organizations, cutting a key source of state Medicaid funding in those states. This policy watch explains how the Finance Committee provision would reduce states’ Medicaid spending, and the implications for expansion states.

This issue brief analyzes the role that immigrants play in the hospital workforce, overall and by occupation and state. Immigrants account for about one in six hospital workers, including among clinical and nonclinical workers.

On May 22, 2025, the U.S. House of Representatives passed a budget reconciliation bill that includes significant reductions in federal Medicaid spending to help offset the cost of tax cuts, along with changes to the Affordable Care Act (ACA), immigration reforms and other provisions. This issue brief discusses the potential implications of the bill for hospitals and explains how some hospitals (such as rural hospitals as well as urban hospitals that serve a large share of Medicaid patients) may be less well positioned than others (such as hospitals that serve a large share of commercial patients) to absorb revenue losses given their current financial status.

Changes to Medicaid funding, eligibility and enrollment could impact hospital finances. These interactive 50-state maps show the number of hospital employees by state and how hospital employment ranks among industry subsectors. Hospitals employed 6.7 million people in 2023, and more than 100,000 people in each of 23 states.

Changes to Medicaid funding, eligibility and enrollment could impact hospital finances. This interactive map shows the number of hospitals in each congressional district. There is at least one hospital in each of the 435 congressional districts.