The most painful health care provisions in the new Republican law don’t take effect for years, giving lobbyists plenty of time to undo them.
Hospitals lost big in President Donald Trump’s megabill, but they still have plenty of time to fight back.
The One Big Beautiful Bill Act that Trump signed on the 4th of July will take a $340 billion bite out of hospital budgets over a decade to pay for tax cuts and other Trump priorities. Then again, maybe it won’t.
That’s because Congress delayed implementation of the most devastating of those cuts till 2028, and hospitals, their armies of lobbyists and many allies on Capitol Hill are already gearing up to use the next two and a half years to persuade lawmakers to rescind them.
And 2028 is not only an election year, but a presidential one.
“Are they really going to want to cut rural hospitals in an election?” asked Chris Mitchell, head of the Iowa Hospital Association. “We’re going to talk to our delegation early and often about the impact of these cuts and how looming cuts down the road impact how hospitals run in the interim.”
Heartening for hospital executives is a now-long history of Congress delaying or repealing the painful parts of major legislation.
Congress, for example, never allowed a tax on high-end “Cadillac” insurance plans in 2010’s Affordable Care Act to take effect, and rescinded a tax on medical devices.