For Ohio health-care leaders, a big worry about H.R. 1 is its potential financial damage to rural and small-town hospitals.
Husted (and his fellow Ohio Republican, Sen. Bernie Moreno, of Westlake) drew in-state praise for an H.R. 1 amendment creating a Rural Health Fund to cushion rural hospitals from of H.R. 1’s Medicaid cuts.
But the journal Health Affairs reports federal officials “must allot 50% of the annual appropriation equally among all states with an approved [Rural Health Fund] application.” That is, if all states apply (they’d be nuts not to) $25 billion over five years will be made available in equal allotments to every state: Hello, 586,000-resident Wyoming, meet 11.99 million-resident Ohio.
The remaining $25 billion for rural health will be allotted with the OK of the federal Centers for Medicare and Medicaid Services’ director, Dr. Mehmet Oz – yes, that Dr. Oz, who, in fairness, earned a Harvard degree and University of Pennsylvania medical and business degrees.
Still, in a column posted by the Center for American Progress think-tank, authors Mia Ives-Rublee and Kim Musheno reported that even “if every rural hospital in the country received an even share of the $50 billion ... [that] would amount to only $4.5 million every year for five years. At the close of those five years, that funding would disappear altogether.”
True, it’s worth noting that Ohio’s Republican-run General Assembly did include in the recently passed 2025-27 state operating budget (House Bill 96) something recommended by Gov. Mike DeWine: A Rural Ohio Hospital Tax Pilot Program to help hospitals in, or serving, certain counties. With their seats, the counties are Fayette (Washington Court House); Greene (Xenia); Highland, (Hillsboro); Hocking (Logan); Muskingum (Zanesville); Perry (New Lexington) Pike (Waverly); Ross (Chillicothe); Scioto (Portsmouth); and Washington (Marietta). Of those, Perry has no in-county acute care hospital.
The how’s-it-work gobbledygook is maddening, but a key aspect, which an Ohio Medicaid Department spokeswoman pointed out, is that “Sen. Husted worked to ensure a [U.S.] Senate provision was added to the [One Big Beautiful Bill Act] that allowed [the Centers for Medicare and Medicaid Services] to consider [such] state proposals if they were submitted before the enactment of H.R. 1.”
And Ohio’s proposals were. That is, without Jon Husted’s amendment, the federal bill would have kayoed DeWine’s and Ohio legislators’ plan to bolster Ohio’s rural hospitals in some counties. So there’s that.
But still, Husted and Moreno voted to pass H.R. 1 overall. And H.R. 1, which Donald Trump signed on July 4, is projected to reduce or end Medicaid coverage for tens of thousands of Ohioans.
Responding to the federal House of Representative’s May 22 passage of the One Big Beautiful Bill, a Greater Cleveland Republican in Congress, U.S. Rep. Dave Joyce, of South Russell said, in a statement reported by cleveland.com’s Sabrina Eaton, that H.R. l “will allow us to enter a new age of economic growth where American families come first.”
Yeah. Right. Unless a family’s broke. And one of its members is sick. And – like 21 of every 100 of Rep. Joyce’s congressional constituents (2024 estimate) – is a Medicaid patient.
Thomas Suddes is a former legislative reporter with The Plain Dealer in Cleveland and writes from Ohio University. You can reach him at tsuddes@gmail.com.
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