Some policymakers and health advocates say Trump’s “One Big Beautiful Bill Act” could be “devastating” to thousands of Missourians who rely on Medicaid and live in rural communities.
According to the Congressional Budget Office, the changes could cause nearly 9 million Americans to lose health care coverage. That includes approximately 130,000 to 160,000 annually in Missouri alone, Sheldon Weisgrau, vice president of health policy and advocacy at the Missouri Foundation for Health, said during a news briefing on Wednesday.
The “One Big Beautiful Bill Act” proposes individuals ages 19 to 64 would need to work at least 80 hours per month to be eligible for Medicaid coverage unless they qualify for an exemption. These exemptions include, but aren’t limited to, people with disabilities, people taking care of dependent children and people who are pregnant.
Missouri state Sen. Patty Lewis, D-Kansas City, described the bill as “devastating.”
Missouri’s Medicaid program, known as MO HealthNet, currently serves approximately 1.25 million people. This includes 660,000 children, 109,000 seniors and 186,000 people with disabilities, according to a joint news release from Lewis and the Missouri Foundation of Health.
Missouri receives $12.7 billion in federal funds from the program, and nearly two-thirds of the state’s Medicaid budget is made up of federal funding.
The bill would also introduce new work requirements for Medicaid recipients and scale back federal funding by an estimated $1.3 trillion over the next decade.
“Patients going through cancer treatment, going through chemo and radiation, who are immunocompromised, could be forced to be out in the community, working when that would be ill advised by their health care providers,” Lewis said.
Missouri has already seen 21 hospital closures since 2014, and another 25 are currently at risk as the proposed legislation moves through Congress. Weisgrau said rural providers could lose up to 21 cents of every Medicaid dollar under the bill.
Weisgrau said these hospitals are the largest or second-largest source of income for rural counties, so the cuts will affect income and lead to job loss if implemented.
“We are likely going to see rural hospitals close,” Weisgrau said. “That means job losses and economic ripple effects.”
MU Health Care and Boone Health are two of the largest hospital systems serving patients across mid-Missouri. Officials say that while the impact is unknown at this time, they are actively watching the legislation.
“This bill is unpopular and will harm and kill people if implemented,” Lewis said. “It’s vital that Missourians contact their representatives now.”
