A new analysis from Public Citizen finds that more than 400 hospitals across the United States are at high risk of closing or cutting services due to Medicaid reductions tied to Trump’s “One Big Beautiful Bill Act.” Black and Latino patients are expected to be hit hardest.
The law reduces federal Medicaid funding by roughly $1 trillion over the next decade, with key provisions phased in beginning in 2027. But hospitals are already responding. Health systems across the country are warning of layoffs, reduced maternity care, and cuts to mental health services as funding contracts.
Texas sits at the center of the crisis. About 80% of Medicaid recipients in the state are people of color, and Texas still has the highest uninsured rate in the nation, in part because it has not expanded Medicaid under the Affordable Care Act. The result is a system already under strain — now facing deeper cuts.
According to the Congressional Budget Office, nearly 12 million people could lose Medicaid coverage nationwide over the next decade. Black Americans, who make up about 20% of Medicaid recipients, are disproportionately exposed to those losses.
These cuts do not exist in isolation. They come alongside federal job losses and SNAP reductions that have already hit Black communities hardest — compounding pressure on the systems many rely on.
Why This Matters
Healthcare access is economic access. When hospitals close in Black and Brown communities, the impact extends beyond care — jobs disappear, services shrink, and stability erodes. What’s emerging isn’t just a smaller safety net, but a system where the communities with the least margin for disruption are asked to absorb the greatest risk.