Durbin, Duckworth Seek Answers On So-Called One Big Beautiful Bill's Impact On Hospitals In Illinois
In a letter that was sent to every hospital in Illinois, Durbin and Duckworth request information about how each hospital anticipates to be impacted by the Republicans’ so-called “One Big Beautiful Bill”
SPRINGFIELD – U.S. Senate Democratic Whip Dick Durbin (D-IL) and U.S. Senator Tammy Duckworth (D-IL) today sent a letter to every hospital in Illinois requesting information about the projected impact analysis of the Republicans’ so-called One Big Beautiful Bill Act, which cuts $1 trillion in Medicaid funding and $300 billion in Affordable Care Act funding over the next decade. As a result of the legislation, 15 million Americans are projected to lose health insurance coverage, including approximately half a million people in Illinois, and hospitals that rely on Medicaid funding, especially those in rural areas, face risk of closure. Further, it’s estimated that 30,000 health care jobs will be lost over the next decade as a result of the bill.
“Earlier this month, Congressional Republicans passed and President Trump signed into law the so-called One Big Beautiful Bill Act (P.L. 119-21). We voted against the measure. We write to request information about how this Republican-passed law will affect your hospital, health care workforce, and the patients you serve across Illinois,” the Senators began their letter.
“The Kaiser Family Foundation estimates that federal Medicaid spending for Illinois will be reduced by 19 percent. These cuts include freezing and reducing provider taxes and state directed payments that hospitals across Illinois depend on to help finance the Medicaid system and make up for low reimbursement rates. The Republican-passed law also will raise uncompensated care costs for hospitals by restricting eligibility and raising out-of-pocket costs for Medicaid and Affordable Care Act beneficiaries,” the Senators continued. “Based upon the estimated 19 percent cut to Medicaid funding, and increased uncompensated care costs from deep insurance coverage losses, we worry that hospitals will face severe financial hardship, and patients will suffer.
Durbin and Duckworth closed their letter by requesting detailed information about the impacts of the so-called One Big Beautiful Bill Act on each hospital, including if patients can expect critical services like obstetrics to be eliminated, how many health care jobs may be lost, and how hospital uncompensated care costs will increase as Illinoisans lose access to their insurance.
“To help inform legislative efforts to improve health care and strengthen hospitals across Illinois, we request the following information and analysis from your hospital about the One Big Beautiful Bill Act by August 22, 2025,” the Senators requested.
“If faced with a 19 percent cut to Medicaid funding as a result of this law, what changes would your hospital be forced to make to maintain viability?” the Senators asked as they concluded their letter.
A copy of the letter is available here and below:
July 25, 2025
Dear Hospital Administrator:
Earlier this month, Congressional Republicans passed and President Trump signed into law the so-called One Big Beautiful Bill Act (P.L. 119-21). We voted against the measure. We write to request information about how this Republican-passed law will affect your hospital, health care workforce, and the patients you serve across Illinois.
Republicans in Congress voted for legislation that cuts $1 trillion in Medicaid funding and $300 billion in Affordable Care Act funding over the next decade. The Kaiser Family Foundation estimates that federal Medicaid spending for Illinois will be reduced by 19 percent. These cuts include freezing and reducing provider taxes and state directed payments that hospitals across Illinois depend on to help finance the Medicaid system and make up for low reimbursement rates. The Republican-passed law also will raise uncompensated care costs for hospitals by restricting eligibility and raising out-of-pocket costs for Medicaid and Affordable Care Act beneficiaries.
Fifteen million Americans are projected to lose health insurance coverage, including approximately half a million people in Illinois—impacting children, pregnant women, seniors, and individuals with disabilities across rural and urban areas. In Illinois, it is estimated that 30,000 health care jobs will be lost over the next decade as a result of this legislation. For rural hospitals that are often the largest employers in a community, this could be devastating.
Hospitals, like any business, must make forecasts and plan their budgets months and years in advance to ensure proper resource allocation and capacity. Based upon the estimated 19 percent cut to Medicaid funding, and increased uncompensated care costs from deep insurance coverage losses, we worry that hospitals will face severe financial hardship, and patients will suffer.
In addition to opposing the One Big Beautiful Bill Act, we have worked on bipartisan legislation to strengthen the health care system, including bills to: bolster the pipeline and recruitment of physicians, nurses, behavioral health providers and dentists; increase funding for rural ambulance services; save rural hospitals facing financial hardship, address maternal mortality and chronic disease; and lower prescription drug costs.
To help inform legislative efforts to improve health care and strengthen hospitals across Illinois, we request the following information and analysis from your hospital about the One Big Beautiful Bill Act by August 22, 2025.
- What percent of your inpatient and outpatient services are paid for by Medicaid, and what percent of such patients are covered by the program?
- What is your hospital’s current operating margin, and, as a result of this law, what do you anticipate it to be in 2028, 2031, and 2034?
- What is the projected annual financial loss to your hospital as a result of this law?
- What is the projected increase in annual uncompensated care provided by your hospital as a result of this law?
- If faced with a 19 percent cut to Medicaid funding as a result of this law, what changes would your hospital be forced to make to maintain viability?
- Please identify which service lines would be the most likely or first to face reductions or termination.
- If your hospital currently offers obstetrics/labor and delivery services, do you anticipate continuing to do so in the same manner by 2030?
- How do you project emergency room wait times will be impacted by this law?
- How do you expect your projected financial losses to affect the economy of your local communities?
- If Congressional Republicans attempt to implement additional Medicaid or Affordable Care Act cuts this Congress, including by reducing or eliminating the 90 percent federal cost-share for Medicaid expansion states, how do you expect this would affect your finances?
Thank you for your attention to this matter, we look forward to your response. Please contact our offices with any questions and to transmit your response.
Sincerely,
-30-