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The loss of federal dollars related to the One Big Beautiful Bill Act could ripple to hospitals like PeaceHealth Cottage Grove, which receive a large portion of revenue from Medicaid.
When President Donald Trump signed the One Big Beautiful Bill Act into law July 4, hospital CEOs in Oregon got heartburn. That’s because the bill includes heavy cuts to Medicaid, the health insurance program for low-income Americans, which is called the Oregon Health Plan here.
Estimates from Princeton University indicate that about 11% of Medicaid enrollees nationally could be affected in the next year. But in Oregon it could be as high as 20%, because the state has aggressively pursued federal dollars for OHP for 30 years.
In 2023, the last year for which the feds have published data, 33.6% of Oregonians were on Medicaid—well above the 27.7% median for all states. Therefore the cuts will fall disproportionately hard on Oregon.
“This is not what Oregonians asked for,” said state Sen. Deb Patterson, D-Salem, chair of the Senate Committee on Health Care. “This Big Brutal Bill may look like a win for corporations, but it is a direct attack on the health and dignity of Oregon families.”
Hospitals, particularly in rural Oregon, will face a double whammy. All hospitals depend on Medicaid payments for a substantial portion of their revenue, and when patients lose Medicaid coverage, hospitals still have to serve them because of federal requirements. The Hospital Association of Oregon says its members get only about 56 cents per dollar of expense from OHP — but that’s better than nothing.
In 2024 Medicaid payments made up 20% of revenue for an average hospital in the state. The hospital with the highest percentage of Medicaid revenue was Hillsboro Medical Center, at 46.7%.
PeaceHealth Cottage Grove Community Medical Center, in southern Lane County, was sixth on the list, with 26.6% of its revenue coming from Medicaid, according to the Oregon Health Authority.
Remote hospitals with fewer than 25 beds receive extra funds for Medicaid services. But even with these supplements, the Hospital Association says most Oregon hospitals lost money in 2024. In Patterson’s estimation, the Big Beautiful Bill is likely to make matters worse.
“Oregon families, seniors and rural communities will be left to pay the price,” she said.
