Virginia hospitals to lose billions under Trump’s Medicaid cuts; job losses could follow

Roughly 323,000 Virginians are expected lose Medicaid or Affordable Care Act coverage because of Trump’s recently-passed budget bill. The cuts to Medicaid also threaten the livelihoods of healthcare workers.

Virginia hospitals across the state are expected to lose billions of dollars in funding because of President Donald Trump’s “Big Beautiful Bill” that substantially cuts Medicaid funding. 

The healthcare impacts of the federal legislation that cuts America’s social safety net to benefit the wealthy were discussed Wednesday at a meeting in Richmond by the Joint Commission on Health Care. 

Cheryl Roberts, the director of Virginia’s Department of Medical Assistance Services, did not give a specific estimate on how much Virginia hospitals are expected to lose. 

But last week, her department’s chief financial officer told lawmakers Trump’s bill was estimated to cause a $26 billion reduction in funding to Virginia hospitals that would lead to “a macroeconomic financial shock, not just to the hospitals, but also for the state writ large,” according to a report by VPM’s Dean Mirshahi. 

At Wednesday’s presentation, Del. Cia Price (D-Newport News) pressed Roberts for more details on the expected costs of Trump’s bill and what the real-world impacts would be, but Roberts declined to provide them, saying she was “nervous about estimates” given how many moving parts there were. Roberts did confirm that the Medicaid reductions for Virginia would be in the billions.

Price told Dogwood she was frustrated about the business-as-usual tenor of the presentation given people’s health care and lives are at stake. She faulted Republican Gov. Glenn Youngkin’s administration for not including more detailed estimates in the presentation.

“When it comes to presentations from the (Youngkin) administration, we do not get those details, and that is deeply concerning,” Price said. “And if that’s the case then for the next meeting we’ll need to invite some of these other partners to hear from.”

An estimated 323,000 Virginians would lose Medicaid or Affordable Care Act coverage because of Trump’s bill. People are also expected to lose coverage because of new reporting requirements and work requirements. 

The cuts to Medicaid also threaten the livelihoods of healthcare workers across Virginia and the US. New research published by the medical journal JAMA estimates that the Medicaid changes in Trump’s bill could result in between 300,000 to 400,000 jobs lost by 2034, though other estimates put the figure even higher. Among those who could lose their jobs are home health care workers whose jobs are paid for through Medicaid waivers, and nursing home staff. An American Health Care Association survey found that more than half of US nursing homes would have to cut staff and that 27% would have to close their facility or facilities.

Doctors, nurses, and other staff at rural hospitals could also face job losses, if the bill’s worst case impacts come to fruition. Rural hospitals disproportionately rely on Medicaid for their patient revenues and are already preparing for the consequences of Trump’s bill. 

Rural Republican lawmakers on Wednesday raised concerns about the possible impacts to their communities. At least half a dozen rural hospitals are at risk of closing in Virginia once Trump’s cuts to Medicaid go into effect, according to one report.

Trump’s bill created a $50 billion grant program for rural hospitals, but it was unclear to state Sen. David Suetterlain (R-Roanoke) if major hospitals in urban areas like Roanoke and Salem that serve substantial rural populations would qualify. National hospital leaders and policy analysts have also raised questions and some skepticism about whether the money will achieve its purported goal. 

State Sen. Chris Head (R-Roanoke) said there is “a foreboding fear among all of the hospital administrators” he’s in touch with given all the uncertainty about their finances. 

“There’s nothing you can do about that until we get some information from Washington about that,” Head said. “But it really is going to be critical for us to come up with a plan to triage because we really are concerned about that a great deal.”