On July 1, the Senate passed a massive spending and tax bill called the “One Big Beautiful Bill Act” by a single vote. Vice President J.D. Vance had to break a 50-50 tie. It’s now headed back to the House of Representatives.

This bill includes over $1 TRILLION in cuts to Medicaid over the next 10 years.

Here’s what that means for us:

• $191 billion cut from provider taxes (funds many rural hospitals rely on)

• $149 billion slashed from state-directed payments — a key funding stream in states like Minnesota

• New work and eligibility rules that will push millions off coverage

• Over 11 million more uninsured Americans by 2034, according to the Congressional Budget Office

Hospitals like Rainy Lake Medical Center — small, rural, and serving high-Medicaid populations—will be hit especially hard.

Cuts like this mean:

• More uncompensated care

• Less revenue to fund staff, services, and equipment

• More pressure on our already stretched team

• And for many rural hospitals, the risk of closure (luckily not ours)

The Senate did include a $25 billion “rural hospital fund” to try to soften the blow. But even the senators who supported it admitted it’s not nearly enough. A last-minute effort to double the fund failed.

Other provisions in the bill include:

• Funding bans for some providers

• Reduced support for legal immigrants and undocumented care

• Cuts to Medicare inflation adjustments

• And limits on ACA marketplace subsidies

The American Hospital Association has already called the bill “deeply disappointing” and warned it will result in longer wait times, reduced services, and fewer staff across the country.

We’re working with the Minnesota Hospital Association and fellow rural hospitals to assess the impact and continue to fight for changes. I’ve also been in contact with lawmakers to make sure our voice is heard loud and clear.

As RLMC’s CEO, I want the community to know: Our commitment is to our staff, our patients, and our community. We are not backing down from this challenge. We’ll keep you informed every step of the way. If you care about healthcare in this community, now’s the time to speak up. Call your representatives. Share your concerns. Let’s make sure rural hospitals don’t get left behind.

– Robb Pastor CEO, Rainy Lake Medical Center

Also, there will be an update on the building project in the newspaper soon.