On Saturday, the federal budget resolution, known as the One Big Beautiful Bill Act, passed a first major vote in the US Senate after passing the House of Representatives the day before. As it was when it arrived at the Senate floor, the bill has now been pared down to 940 pages from over 1,000, yet still contains a sweeping array of cuts to nearly all areas of public spending in order to accommodate over $1 trillion in tax cuts for high incomes. The bill also includes a provision to allow for an increase of $5 trillion to the US national debt ceiling.
One of the sectors most visibly hit by the proposal remains healthcare. While the Senate’s version of the resolution initially appeared to reduce the overall impact of cuts, the Senate bill now appears to currently deepen cuts to Medicaid, including cuts to payments for hospital emergency services, state-directed payments for medical care, and banning states from providing healthcare eligibility for lawfully present immigrants.
In particular, US Senators for Illinois Dick Durbin and Tammy Duckworth have highlighted new findings that show their Republican colleagues’ reconciliation bill puts 579 nursing homes across the country at risk of closure.
Based on data compiled by Brown University’s School of Public Health, and released by Senate Finance Committee Ranking Member U.S. Senator Ron Wyden (D-OR) and U.S. Senator Mark Warner (D-VA), the Republicans’ One Big Beautiful Bill Act endangers the operations of 93 nursing homes in Illinois.
According to the American Council on Aging, the average annual cost of a nursing home in Illinois is $94,900, which is not feasible for many Illinoisans to pay without assistance. Despite Medicaid covering 63 percent of residents in nursing homes and the high price of care, Republicans’ plan to slash Medicaid funding by $800 billion endangers the ability of thousands of Americans, many of whom are seniors or people with disabilities, to access the care they need.
While states are required to provide nursing home care under Medicaid, states are not required to offer home and community-based service waiver programs that allow Americans to receive in-home or nearby care. If passed, the Republicans’ plan could threaten home and community-based service waiver programs, increasing demand for already strained nursing homes.
Durbin told the press, “President Trump and congressional Republicans are pursuing legislation that rips health care coverage from 16 million Americans and slashes $800 billion in Medicaid funding in order to serve up a sizeable tax cut for billionaires… It is unconscionable that Republicans would prioritize enriching the wealthy over ensuring the safe care and treatment of seniors and adults with disabilities.”
Both red and blue states stand to lose, Democrats argue, if Republicans push through the legislation as it is. Under the plan, 39 nursing homes in Missouri are at high-risk of closing while Ohio and Texas could lose 41 and 66 nursing homes, respectively.
Duckworth said, “The devastating cuts to nursing homes under this Republican legislation are in addition to the bill forcing 16 million Americans to lose their health insurance coverage, which also risks the closure of rural and safety net hospitals nationwide. Donald Trump and Republicans are trying to sell out those most in need to fund a tax cut for billionaires.
“That’s not just fiscally irresponsible,” she continued, “it’s morally wrong. If this so-called Big Beautiful Bill passes, nearly 100 nursing homes across our state will be at risk of closing. And it won’t just be Medicaid recipients and those most in need who are hurt by these extreme Republican cuts. When health facilities close, that means whole communities—even privately insured Illinoisans—lose access too.”
