The One Big Beautiful Bill Act’s changes to premium subsidies and Medicaid eligibility are projected to reduce hospital revenue nationwide by $68.5 billion over 2026 and 2027, according to a Dec. 15 report from Premier.
Six things to know:
1. Premier is estimating a $33.6 billion reduction in commercial revenue, a $22.4 billion reduction in Medicaid revenue and a $12.5 billion increase in uncompensated care.
2. Premier’s data predicts that most hospitals will see a net patient revenue reduction between 2% and 10%, with some at the extreme end of the scale seeing reductions of more than 20%.
3. On average, per facility, Florida hospitals are predicted to face the largest deficit at $51.8 million per hospital. Florida is followed by the District of Columbia ($38.9 million), South Carolina ($38.3 million), Georgia ($34.4 million) and Texas ($32.6 million).
4. Across all hospitals within a state, the total anticipated effect is largely driven by population, according to the report. When accounting for population, Texas is projected to see the largest total effect of $11.5 billion, followed by Florida ($8.8 billion) California ($4.9 billion), New York ($4.3 billion) and Georgia ($4.3 billion).
5. Citing data from Definitive Healthcare, Premier said there are nine health systems in the U.S. with net patient revenue exceeding $5 billion. The effects of the OBBBA shifts in insurance coverage is expected to range between $58.6 billion and $997.6 million when measured in dollars, and between 0.9% and 12.3% when measured as a change in net patient revenue.
6. Uncompensated care is projected to rise from $32.4 billion to $44.9 billion, a 38.6% increase. Premier said some systems are projected to see a $100 million to $200 million increase in uncompensated care.
Read the full report here.
