ICYMI: Trump’s Big Ugly Bill — Supported by Sununu and Brown — Cuts “Key Source of Funding For Rural Hospitals and Health Centers”

ICYMI: Trump’s Big Ugly Bill — Supported by Sununu and Brown — Cuts “Key Source of Funding For Rural Hospitals and Health Centers”

In Case You Missed It, recent reporting from Business NH Magazine shows “New Hampshire stands to lose an estimated $2 billion to $3 billion in [Medicaid] funding over the next decade” due to Donald Trump’s Big Ugly Bill, which U.S. Senate candidates John Sununu and Scott Brown both support.

A nonprofit health care clinic in Franconia has already closed citing the Medicaid cuts, and tens of thousands of Granite Staters are at risk of losing their health insurance, yet Sununu celebrated the Medicaid cuts, claiming Republicans “did the right thing,” and Brown said, “I support” Trump’s Big Ugly Bill.

Read more below about how Trump’s Big Ugly Bill is devastating New Hampshire’s health care system:

Business NH Magazine: New Rural Health Funding Only a Bandage for Medicaid Wound

[...] Rural areas of NH tend to have higher rates of poverty and chronic disease, and patients there face a host of barriers to accessing care. Among them are long travel times, spotty emergency medical services coverage, shortages of health care professionals, and the steady erosion of maternity care and other essential services. These last two are especially hard to maintain in areas with low population density and limited resources.
[...] But the same law includes steep cuts to Medicaid, the safety-net insurance program that’s a key source of funding for rural hospitals and health centers. New Hampshire stands to lose an estimated $2 billion to $3 billion in funding over the next decade— more, notably, then the state will gain.
Health care providers say the new Rural Health Transformation funds are welcome but won’t be enough to compensate for those losses. One nonprofit clinic in northern NH, Ammonoosuc Community Health Services’ Franconia location, has already closed its doors because of the cuts.
[...] The bill, which passed last July with the backing of President Donald Trump, includes work requirements and other provisions projected to reduce federal Medicaid spending by more than $900 billion over the next decade, according to estimates from the nonpartisan Congressional Budget Office. An additional 7.5 million people are projected to become uninsured as a result.
In NH, anywhere from 14,000 to 29,000 Granite Staters could lose health coverage under the law, depending on how the state implements it, according to a report from the Robert Wood Johnson Foundation and the Urban Institute.
[...] According to an analysis by the health policy organization KFF, rural communities stand to lose $137 billion in Medicaid funding over the next 10 years, nearly three times as much as they’ll receive in Rural Health Transformation grants.
“It doesn’t impact just Medicaid patients,” says Steve Ahnen, president of the NH Hospital Association. “It impacts everybody, because those resources are used to support the broader health care system.”
Ahnen says NH’s hospitals are already under pressure from rising labor costs, workforce shortages and other challenges, even before factoring in the Medicaid cuts. And rural hospitals, with a patient mix that tends to be older and less well-off, are especially dependent on revenue from Medicaid and Medicare.
According to the hospital association’s most recent data, seven NH hospitals had negative operating margins in 2024, including four rural critical access hospitals.
The state’s nonprofit community health centers are also bracing for a rise in uncompensated care as more patients lose insurance due to the changes to both Medicaid and the Affordable Care Act premium subsidies, says Georgia Maheras, senior vice president for policy and strategy at the Bi-State Primary Care Association, a nonprofit that represents community health centers and safety-net providers serving more than 344,600 patients at 175 locations throughout NH and Vermont.
“Our health centers are community focused, are seeing people regardless of their ability to pay, and that gets increasingly hard if they don’t have enough revenue coming in the door,” she says. “You know the adage—‘no margin, no mission.’”
That impact is already being felt. Ammonoosuc Community Health Services, a health center with several locations in northern NH, closed its clinic in Franconia last year, citing the anticipated loss of about $500,000 annually in Medicaid revenue. Some 2,000 patients now must drive to locations in Whitefield or Littleton.
CEO Ed Shanshala says the decision was tough, but the organization had to cut expenses to offset the Big Beautiful Bill’s impact. “It changes the fabric of the community, and it’s a loss,” Shanshala says. “In rural areas, when businesses close, they often don’t come back—health care being the same.”
[...]

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