The recent passage of President Donald Trump’s landmark tax bill by the U.S. House has sparked significant concerns among health care advocates and Illinois residents, as it threatens the closure of nine hospitals across the state.
Additionally, the legislation could result in more than 427,000 people losing access to food assistance plans and over 500,000 low-income residents facing the loss of health care coverage.
This tax reform, touted as one of Trump’s major second term victories, is expected to remove over 11 million Americans from health insurance within the next decade, aimed at offsetting $4.5 trillion in tax cuts.
Trump is anticipated to commemorate the bill’s passage with a signing ceremony on the Fourth of July.
Illinois health care advocates, alongside the SEIU Healthcare union representing more than 91,000 workers in the region, have raised alarm about the potential fallout from this legislation on safety net hospitals.
These hospitals, defined as those with at least 70% Medicaid utilization, are predicted to experience severe operational strain due to the new Medicaid work requirements set to take effect at the end of 2026.
With enrollment expected to decline, safety net hospitals will face an increased number of uninsured patients needing charity care, alongside losing critical Medicaid reimbursement payments.
This threat of closure looms large as health care workers also face job insecurity tied to reduced services, prompting the SEIU to pivot its focus toward finding new state revenue in light of the bill’s devastating cuts.
The union has emphasized the importance of keeping these cuts in the public’s eye, especially with midterm elections approaching, as many of the changes will not be felt immediately and are scheduled for implementation in 2026 and 2028.
Alice Jones, a unit secretary at Mount Sinai Hospital’s emergency room, expressed deep concerns about the potential influx of uninsured patients.
She anticipates that the emergency department will become enormously overwhelmed, exacerbated by the inability of Medicaid patients to access necessary specialty clinics due to the impending cuts.
Jones, who has dedicated 35 years of service to the hospital, lamented the harsh reality of the bill’s impact.
“It appears to be very drastic for people,” Jones stated, emphasizing the injustices faced by those who are poor and unable to secure adequate health care.
In response to these concerns, the Illinois Hospital Association has voiced that hospitals will be compelled to make painful choices, potentially resulting in complete closures.
A.J. Wilhelmi, President and CEO of the association, lamented the anticipated healthcare loss for hundreds of thousands of Illinois residents.
He noted that while hospitals will continue their care obligations to uninsured patients, doing so will lead to compromised services, staffing reductions, and increased healthcare costs for everyone.
Governor JB Pritzker’s administration has estimated that up to 500,000 Illinoisans may lose their Medicaid coverage as a result of the federal bill’s new requirements, mandating that the majority of the state’s 3 million-plus enrollees prove they have worked, volunteered, or pursued education for a minimum of 80 hours monthly before re-enrollment.
The Illinois Department of Healthcare and Family Services currently does not track the work statuses of Medicaid recipients, raising questions about the state’s capacity to enforce these new regulations.
Moreover, the proposed overhaul of the Supplemental Nutrition Assistance Program (SNAP) is projected to inflict a fiscal burden of $1.2 billion on Illinois, as outlined by the governor’s office.
The state’s congressional delegation voted unanimously along party lines against the bill.
U.S. Rep. Darin LaHood, R-Ill., characterized the measure as an economic booster for the United States, asserting that it offers stability for small businesses and historic tax relief for Americans.
Despite the potential losses for numerous constituents, including food assistance and Medicaid coverage, LaHood maintained that the bill represents a triumph for his 16th District.
Ahead of the vote, Governor Pritzker reached out to the Republican members of the Illinois delegation, expressing his profound concerns regarding the bill’s impact, particularly on rural areas.
In his correspondence, he outlined the estimated number of individuals in their districts who would be affected by the loss of Medicaid coverage, highlighting that over 15,000 individuals in LaHood’s district could be affected.
Pritzker cautioned that Medicaid cuts could lead to severe service reductions or closures at nine rural hospitals, impacting approximately 54,000 residents in rural Illinois.
He indicated that if H.R. 1 becomes law, many hospitals may be forced to eliminate essential services, reduce staff, or shut their doors entirely, resulting in ripple effects damaging the health care landscape for all patients in their communities, regardless of their Medicaid status.
The nine rural hospitals identified as at risk of closure include OSF Sacred Heart Medical Center in Danville, Hoopeston Community Memorial Hospital, Crawford Memorial Hospital in Robinson, Richland Memorial Hospital in Olney, Harrisburg Medical Center, Franklin Hospital in Benton, Massac Memorial Hospital in Metropolis, Hardin County General Hospital in Rosiclare, and Katherine Shaw Bethea Hospital in Dixon.
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