Urban Hospitals Warn of Medicaid Crisis as Senate Advances Rural-Only Relief – Black Book Flash Poll

Senate’s rural hospital protections leave urban safety-net providers facing financial fallout and potential care cutbacks, new poll results reveal.

WASHINGTON, June 29, 2025 (Newswire.com)
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As the Senate advances the amended “One Big Beautiful Bill,” granting critical Medicaid relief exclusively to rural hospitals, urban safety-net hospitals are left facing significant financial peril, according to a flash poll by independent research firm Black Book Research. The survey, conducted June 25-28, 2025, gathered urgent perspectives from twelve senior executives at major urban hospitals averaging 440 beds and a Medicaid payer mix of 67%. Respondents included leaders in finance, clinical operations, and health IT.

Key findings signal unanimous concern among urban safety-net executives:

All respondents anticipate serious financial harm from pending Medicaid funding cuts. Additonally, every executive reported that their state has no viable contingency plan to address the shortfall from reduced federal Medicaid matching funds.

Seven of twelve foresee major operational consequences: significant reductions in healthcare services, layoffs, or deferral of essential investments in cybersecurity and technology infrastructure. The average projected uncompensated care expenses exceed $10 million per facility annually.

Two executives warn of even more severe outcomes: the potential for closure or bankruptcy of their health systems within three years without legislative intervention.

Independent assessments echo these concerns, finding that the current bill could impose severe financial burdens on urban hospitals due to Medicaid provider tax reductions. Leaders caution that the lack of urban protections may undermine care for millions of vulnerable urban residents and destabilize existing safety nets.

“While rural hospitals rightly received critical protections, urban safety-net hospitals have clearly been overlooked. Without comparable safeguards, vital healthcare services for millions of Medicaid-dependent urban residents are at risk, ” commented Doug Brown, Founder of Black Book Research. “Our flash poll highlights the urgent need for equity in the final bill negotiations. Congressional leaders must recognize the indispensable role urban safety-net hospitals play in delivering care to the nation’s most underserved populations.”

Urban hospital administrators urge lawmakers to ensure balanced, equitable emergency protections in ongoing legislative negotiations, calling for relief that supports the essential needs of both rural and urban hospitals.

How to Advocate: Hospital administrators and stakeholders are encouraged to contact their senators and representatives directly via www.congress.gov/members.

About Black Book Research

Black Book Research is an independent research firm specializing in healthcare market trends, vendor rankings, and provider insights. Employing impartial, data-driven methodologies and comprehensive surveys, Black Book tracks healthcare technology adoption and policy impacts while amplifying provider perspectives and identifying industry gaps.

Black Book’s rapid flash polling utilizes expert panels from both in-house and outsourced partners, ensuring timely, actionable intelligence on market and policy shifts. Access complimentary industry reports at www.blackbookmarketresearch.com or contact research@blackbookmarketresearch.com.

Source: Black Book Research