About a week and a half after the passing of the Big Beautiful Bill, local hospitals are trying to sort through the law to determine how the changes to Medicaid will impact the operations and their patients. Many officials say that it’s simply too early to tell.

“At this time, it’s too early to determine what direct impact this legislation will have on Logan Health, our services or our facilities,” Chris Leopold, Senior Marketing Coordinator for Logan Health, stated in an email. “We are still working to understand all of the details in the legislation. We are closely monitoring the situation and will continue to evaluate what it could mean for our patients, our communities and our organization moving forward.”

At critical access hospitals like Cabinet Peaks Medical Center in Libby, hospital administrators are striving to provide some reassurance amidst the uncertainty.

“While we recognize that there may be some financial impact, we want to reassure our staff, patients and community that we do not anticipate any cancellation of services or release of employees as a result,” stated CEO Tadd Greenfield. “Over the years, we have worked diligently to build a strong foundation of financial stability, making thoughtful, strategic decisions to ensure the long-term health of our organization.”

Some of the federal Medicaid addendums entail work requirements that generally require those enrolled in a state Medicaid plan to work 80 hours each month, perform the equivalent in community service hours or be enrolled in an educational program at least half-time. The law also permits more frequent compliance verifications.

For Medicaid in Montana, a work requirement has been looming since the passage of House Bill 658 during the 2019 state legislative session, but it was unable to be implemented without federal approval. The requirement was approved again along with Medicaid expansion during the most recent legislative session earlier this year. It can now finally move forward in light of the new federal requirements.

“Our leaders at the Montana Hospital Association were confident that the structures set up at the state level allow Montana to fair better than other states, though not without impact,” said Erin Rumelhart, Director of Nursing and Operations at Providence Health, a member of the association. “Essentially, Montana has modeled itself similarly after the federal Medicaid and Medicare model. I do feel fairly confident that we will continue to be able to provide care. It doesn’t come without potential impacts. I just don’t know if we know yet.”

In addition to work requirements, the law includes more stringent measures to limit federal Medicaid expenditures such as reducing the number of months that a person can retroactively apply for coverage, stopping all federal Medicaid dollars for one year to nonprofit health care providers if they primarily offer family planning or reproductive health services, and capping the amount that states can tax patient service revenues to receive matching federal funds. Many are not set to go into effect until after 2026.

While providers continue to wade through the details of the law and how they’ll impact care, some looking for alternatives to supplement the fewer federal dollars coming in point toward philanthropy as a potential solution.

Prior to a groundbreaking ceremony for a rural health clinic at the Providence St. Joseph Medical Center in Polson yesterday, Chief Administrative Officer Caryl Perdaems said that the hospital has begun to rely heavily on donor support.

“I think when you’re looking at a trillion dollars in Medicaid cuts, that’s going to affect everybody,” said Perdaems. “We’re planning strategies to look at how we are lifting up our programs, but we’re also leaning into our donor support.”

Within the past year, the hospital raised about $14 million for the new clinic, the first part of a larger campaign to improve rural healthcare in the south Flathead Valley.

“As a healthcare system, our philanthropy and donor support is huge to our success in opening new clinics like this,” said Perdaems.

I’ll be continuing to keep a pulse on the potential fallout due to changes in Medicaid, but in the meantime, keep an eye out for a full debriefing of the rural health clinic campaign within the next 24 hours.

I’m Zoë Buhrmaster, here with you for the rest of today’s Daily Roundup.