Republicans were aware that the passage of President Donald Trump's "big, beautiful bill" could damage their midterm prospects due to the vast array of health care cuts that finance the legislation. So they crafted a plan to insulate themselves: the Medicaid cuts don't start taking effect until 2027, while the tax cuts in the bill, like deductions on tips, are rolled out immediately.
But although Democratic strategists are aware this makes their job of attacking the legislation harder, reported Politico, there is one element to the GOP's plan that is shaky. Rural hospitals are starting to shutter long before the Medicaid cuts take effect.
"This cycle, Democrats have eyed redder seats in Kentucky, Florida and Virginia as they try to push into GOP-held territory," reported Politico. "That’s in part because, though most of the pain was put off as long as possible, some of the effects — like on rural hospitals that have to budget on longer timelines — could be felt sooner."
Former Kentucky state Rep. Cherlynn Stevenson, who is running for a vacant congressional seat Democrats tried and failed to flip in the 2018 midterms amid another health care backlash, told Politico, “We will need to remind voters that the impact is going to kind of come in waves, and that a lot of the brunt of the damage won’t be felt until next year, or even after the midterms. We just will have to remind them that provisions of the bill are still coming, that deadlines are looming.”
Throughout the process of the bill's legislation, hospital executives were desperately warning that the cuts could result in closures of rural hospitals around the country, leaving areas without easy access to medical care. Republicans have tried to mitigate this issue by creating a bailout fund for affected hospitals, but that fund is a tiny fraction of the cuts Medicaid will experience over the next decade.
This also comes as some Republicans are already advocating some changes to the legislation to blunt the potential impact.
"Some GOP lawmakers who voted for the megabill are already pushing to stop some of the harsher provisions — like changes to the provider tax that could have an adverse effect on rural hospitals — from taking effect," noted the report, with Sen. Josh Hawley (R-MO) saying last week, “If Republicans don’t want to be accused of cutting Medicaid, it’s probably a good idea not to cut Medicaid.”
Hawley backed the bill despite weeks of voicing concern about the cuts.
