...to fill in the care gaps, save their smaller and more rural hospitals already financially teetering and protect their most vulnerable whose health and wellness will suffer. Small consolation that more ill will fall on red states but pity the innocents.

It’s a feature not a bug!

Passage of the budget reconciliation law signed into law by President Trump (HR1) will result in a gross reduction of $990 billion in federal Medicaid and CHIP spending over 10 years and an increase in the number of uninsured Americans of 10 million. These are the largest health cuts in Medicaid’s history, and passage of the bill was delayed by worries that rural hospitals across the United States would be put at further risk of closing because so many of their patients rely on Medicaid. KFF estimates that HR1 will reduce federal Medicaid spending in rural areas across all states by $137 billion over 10 years.
To ensure passage, Congress included a $50 billion “Rural Health Transformation Fund” (or RHTF).


In the end, what was characterized by many as a “rural hospital fund” is really nothing of the sort. The vast majority of RHTF funding is actually prohibited from directly benefiting health care providers, including rural hospitals. Members of Congress may have had different motivations for passing HR1, but the implementation of the law around the RHTF is different than the assurances around help for rural hospitals many policymakers gave the public.


https://ccf.georgetown.edu/2025/10/21/trump-administration-severely-limits-funding-for-rural-hospitals-and-clinics-from-rural-health-transformation-fund-capped-at-15/

sealed the fate of the lower 99%.................We are gonna be obliterated, at an ACCELERATING rate....JUST LOOK AT WHAT THEY HAVE ACCOMPLISHED SINCE JAN 20TH.....

If you think it is bad now.......YOU AIN'T SEEN NOTHING YET FOLKS...........

We are all gonna get creamed, and the Republicans have already begun trashing even their own MAGAot voters, ESPECIALLY THEIR MASSIVE AMOUNT OF UN-EDUCATED, POOR, RURAL VOTERS........Rural medicine was already bad enough, now it is becoming non-existent at an acelleratingly rapid rate, they are wiping out Rural Doctors, Nurses, Rural small hospitals, etc. Their doing that has definitely been a boom to the medical helicopter patient transport businesses and the price of a helicopter transport has become astronomical, with most insurances covering only a small portion of the cost, if any at all.........Whatever you do, if you are in Rural America, don't get critically ill or have an accident.....
What, we, in EMS call the "GOLDEN HOUR" .........doesn't exist....

For the past 50 years, People have joked that the mantra for the Republican's plan for Health Care is IF YOU GET SICK, DIE QUICKLY......

The perfect title for a book about the last 45+ years would be: WHILE THE NATION SLEPT........

The Repubs have been chipping away, every chance they have had, since corruptly installing Reagan in the White House......and here we are today with all their tireless work coming to a head........and with TONs of CHECK MATES...........

If it is an emergency, the airlift company can only bill the in-network price, even if they are not in the patient's network. This has been in effect since January 1, 2022, a result of the No Surprises Act.

What the patient pays is determined by the cost-sharing terms of the patient's insurance plan, but in many plans transportation is covered at 100% for emergencies.

"Balance billing" is no longer allowed per the No Surprises Act.

We live in rural Nevada and my husband recently took a 30-minute helicopter flight to a hospital. The bill submitted to the insurance company was about $51,000. I'm not sure how much the insurance company paid them. But he didn't have to pay any of it because he has already reached his out-of-pocket maximum for the year.

Emergency situations include injury resulting from an accident, or illness with acute symptoms like hemorrhage, shock, chest pain, respiratory distress, etc. Or oxygen administration due to hypoxemia, syncope, airway obstruction, or chest pain.

so what you are saying doesn't jive with the way it used to be for ground transport OR air transport. Especially, the maladies mentioned in your last sentence, which we classified as an ALS run .......I will have to check into if what you say is true for Colorado, because that would be incredibly better than the way it was even a few years ago.

Thx.....I will check on it!

I will also check on what Colorado Kaiser is doing, because they dance to a different drummer on what they cover and what they don't in emergency medicine situations....at least it used to be that way.......the stories I could tell................

believe they do know what will happen and they just really DON’T CARE!

Really sick of this

Instead of transitioning to nonprofit healthcare, we'll be listening to politicians arguing how much each of us should give to insurance companies

ever have more equitable governance.

that has more members working for the people than insurance/hospital corporations.

That won't happen any time soon.

marketplace. We already have savings plans, HSA, and funding vouchers is done with government money.

What will feed the greed of insurance companies when Americans can't afford insurance?

able to force Americans to give to insurance companies?

Pay to renew a license, buy tabs, etc

If you don't you're penalized. Which was actually how the ACA started out, trying to penalize people who didn't get insurance. Guess they saw how unpopular that was

hospitals to stabilize patients...so, you'll have to have some kind of insurance to cover if you should have an accident or an emergency or you'll die outside the ER becasue they can't let you in without proof of insurance, even if you are bleeding out.

Then, they'll make it a law that you MUST buy insurance and once that is in place, you're stuck, you have to buy it and the companies set the prices and the level of care you get.

They could buy a hospital if they want to.

🙄

It's going to be ridiculously difficult to get care
for so many.

there’s a couple hospitals here in chgo that uninsured folks know will take them. some of those will close. unless, like northwestern, they have a huge endowment for charity care.
that er is already the 9th circle of hell, tho. i cant imagine what it will b like if even 1 other hospital folds.

That think it's fine to toss the dreaded Obamacare because they have ACA...and are too stupid to know that they are one in the same.

Not just health, but auto-insurance, Dental, home, umbrella . . .

We're at double-digit inflation in most areas and I think few are talking about a solution.

People complain about the greed of insurance companies but aren't looking at the root causes.

Went up 330% last month. Oh, they added coverage for bed bugs.

Replacing ACA is a whole lot more than cutting millions of checks every month. Finding out the hard war will be both painful and expensive.

The only "death panels" I've seen in the American for-profit healthcare system are insurance company executives.

Two of my doctors and homeowners insurance co. have AI as their front line of defense.

make a ton of money selling ACA policies. That money will be gone and the profits will have to be made up somewhere. Also, I believe many on the ACA are younger, self employed, small businesses, etc. they will now drop their insurance, so the companies will have more older and sicker folk that will increase their costs. There are many reasons why everyone but the wealthy will be hurt by this. The wealthy investors in healthcare will not lose a dime.

and have been switching my doctors to Pittsburgh. My wife was in the hospital 3 years ago, the emergency room. We had to wait in the hallway for a room to open up. She was in the hospital for 2 days and those 2 days people were still waiting in the hallway when we left.

Now, it is going to get worse. The one ER doctor had 45 patients.

There are a lot of inherent problems in the profession that are not being addressed and they are getting worse.

And erosion of the tax base. The ACA is also a job creation program. A lot of healthcare workers are going to get let go and medical facilities closed. This will happen well before folks get sick and start setting up gofundme accounts for medical care.

In 2024 I paid $55/month. In 2025 it was $79/month. According to the Connect for Colorado Healthcare Exchange, my 2026 premium will be $95/month with subsides and $1000/month with no subsidies.

I just can't believe the Dems would throw away Obama's legacy like that. Maybe I'm in denial, but I have no other choice but to believe the Dems will make these subsidies happen before the end of the year. If they have to give up on the Epstein vote, so be it. We all have choices to make and me not dying is more important to me.

"24 million people have Obamacare, 22 million get subsidies."

"Costs are going to double and triple for those people." i.e the 22 million)

"The CBO estimates that 4 million more people will become uninsured."

So the CBO believes that 18 million people can afford to pay an additional $5000 - $10,000, even $20,000 a year more? WTF?

https://www.kff.org/affordable-care-act/aca-marketplace-premium-payments-would-more-than-double-on-average-next-year-if-enhanced-premium-tax-credits-expire/

It wasn't very clear especially using the word an additional 4 million people.

As Trump's actions continue to tank the economy.

Yes, the ER's across the nation will become swamped with uninsured patients in crisis stages. This is the most expensive area of medicine and it will bankrupt a lot of hospitals forced to bear the costs of limited or non-reimbursed costs associated with it. It's far more cost-effective to provide preventive care to manage pre-existing conditions before they become acute. The insurance companies are getting a free ride by only covering folks in good health. But the costs of delivering all levels of care must be spread out across the entire risk pool of patients to remain viable and fair. So something like a "Medicare for All" plan is needed to fix this. And more hospitals must be built and fully staffed. Perhaps the VA hospital system could be expanded and funded to include civilian patients.

I have no money to pay for increased health insurance.
As a (very) senior who lives on Social Security, I struggle to pay the bills. I live like a pauper.
Without sponsored healthcare like Medicare,, I will just cope with no coverage and hope my kids have enough money to pay for my funeral.
Yes, it is that bad for countless Americans. WE have paid into the system for .50....60.. years or more.. This is a slap in the face.
Obviously trump and the re-thugs are looking to clear us out.

Take no subsidies or credits. Retired, but not 65. Keeping same plan from 2025 to 2026 with no changes equals a 44% increase or an additional $419 a month in whole dollars--another $5,000 a year. And the kicker? Same plan this year had no deductable---2026 now has a $2,200 dedeuctable that needs to be met first. I can swing it--but SHEESH.

It looks like they are getting what they want.

The idea is that the Tech Bros have determined that they just don’t need so many humans. Robots and AI can do most of the work. There will be even more useless eaters in the future …unless there aren’t

I’m sorry but how many things are we seeing that supports that?

There are people on both sides who don't like insurance companies getting that money.

So there is plenty of evidence showing their plan is to cull the herd to reduce the US population.

That’ll take care of a couple hundred thousand

I remember hearing something during Iraq, ex US military officer on CNN said “Let’s not forget, it’s cheaper to kill a million people than govern them”.
I remember the chill up my spine

ACA, also known as Obama Care, is NOT just about money going to insurance companies. It is ALSO about putting regulations ON insurance companies.

It's about requiring insurance companies to spend a certain % of what they charge on actual medical care payments. If an insurer does not spend that % of the premiums they collect on actual care, they must refund or lower the rates they charge. ACA limits the % of profits insurance companies can make! Without some regulation, insurers have no incentive to pay for claims, they can deny more and more to assure THEY get more profits.

The ACA puts demands on insurers to cover every client, not just the ones who don't use a lot of health care. It keeps them from only covering healthy people and refusing to cover people with per-existing conditions.
Ending ACA would mean the people who need coverage the most would be unable to get health insurance, or it would be as such a high cost that most would be unable to afford it, which is essentially the same as them not being allowed into the insurance programs.

Trump thinks everyone is as ignorant as his maga voters. He thinks he can pretend they are saving money, or getting money back when what he is trying to do is give Big Insurance the OK to deny claims and/or deny coverage to people more likely to need care and have claims. in order to make obscene profits again.

If it was just about helping people by subsidizing premiums, insurance companies would LOVE the ACA! But it was also about putting regulations on the companies and governing how they can do business, requirements on how the companies have to provide payments for actual health care.

Get the word out. Remind everyone. Not only will rates go up for folks who were getting subsidies, but services will go down for all of us.

Edited to add: Gonna post this as an OP so more will remember what this is REALLY about: regulating insurers.

The collateral issues will affect all of us.

Their big donors want them to get rid of the ACA because it imposes some regulations holding the industry responsible for actually providing what people pay for. Fat Cats are not known for doing their share.

After one of those Fat Cats was gunned down, one might think the rest of them would stop being such greedy pigs that too often cause the demise of their clients, but.. NOOOOOOOOO they still don't get it.

It was my understanding it was just de-funding the subsidies.

going back over 30 years. Generations have been raised on this crap. People are not going to just snap back into their senses. But they do still think that they have all of the entitlements they have always had. Many think is was the Republicans who gave them those entitlements in the first place. Such is the nature of 24/7/365 propaganda.

These people are not going to understand what Trump and MAGA are doing until it is personally shoved right down their throats. Not the other guy, not the brown people, not "Antifa", not liberals and progressives but right down their own throats.

In 1929 and the resulting years, Americans faced extreme hardship and there was no question on who was responsible for it. As a result, the Republicans were sent out into the political wilderness for 50 years.

I am concerned that it is going to take another event like the 1929 stock market crash to finally wake the people up.

but that was not enough to keep the doors open. A church congregation in the Netherlands read about the pathetic realities of medical care in rural America and decided to help the struggling people in the US. They funded a big part of that local clinic.

Yep, foreign people saw a sad situation and THEY have been sending money to help. Yet those local people in that US county keep voting for GOP pols who create and maintain the situation that impoverishes their community.

Those people don't really want to solve their problems. They get too much joy wallowing in their problems and supporting the pols whose policies create/maintain those problems.

We need better education and mental health care in this nation of we will never get things working well for the average citizen.

if their holiday travel was disrupted