AUGUSTA, Maine — Maine’s largest employer and other health care providers are facing huge financial consequences after the U.S. Senate narrowly passed President Donald Trump’s “big, beautiful bill” of tax breaks and Medicaid cuts Tuesday.
Before reaching Trump ahead of his preferred July 4 deadline, the roughly 900-page megabill that would extend the 2017 tax cuts and increase the federal deficit by $3 trillion must win final approval from the House, which passed its version by only one vote in May. Vice President JD Vance broke a 50-50 tie in the Senate to pass the bill Tuesday, with opposition from Republican Sens. Susan Collins of Maine, Rand Paul of Kentucky and Thom Tillis of North Carolina.
Collins, who cast a key vote over the weekend to advance the bill to the final vote before eventually opposing it, had proposed the creation of a $50 billion fund to help rural hospitals amid the bill leading to an estimated $930 billion in Medicaid cuts. Although senators defeated Collins’ amendment, separate talks led to members including the $50 billion fund.
Maine hospitals are still facing drastic changes if Trump signs off on his priority tax and domestic policy legislation. That comes on top of health care providers facing financial pain and service cuts after the Legislature fought earlier this year over a MaineCare bailout.
Recent studies found the Medicaid cuts could put hospitals in Calais, Presque Isle, Caribou and Ellsworth among more than 300 rural hospitals nationally at risk of closing. MaineHealth, the state’s largest employer with about 24,000 employees, is bracing for “undue amounts of pain,” Katie Fullam Harris, the system’s chief government affairs officer, said Tuesday.
Harris said MaineHealth was looking at losing between $40 million and $60 million annually under the House version and “at least that amount and probably more” under the Senate version. Harris said system officials are huddling over next steps, adding they appreciate how Collins voted against the bill but view the rural hospital fund she pushed for as inadequate.
“You can’t take $1 trillion out of a health care system and replace it with $50 billion and expect there won’t be massive consequences with the cuts that will ensue,” Harris said.
The Congressional Budget Office also found cuts to Medicaid and Affordable Care Act tax credits under the megabill will cause around 17 million Americans to lose health insurance by 2034, with studies pointing to up to roughly 60,000 Mainers losing coverage under the bill and its implementation of work requirements for the low-income health insurance program.
The stress comes at a challenging time for Maine hospitals. The larger ones are the fifth-poorest in the U.S., according to a study released in the spring. Paul Bolin, executive vice president of Brewer-based Northern Light Health, which is in the midst of significant financial struggles, is “optimistic that ultimately we’ll avoid some of the most detrimental changes that could be in place.”
“But we need to be prepared for anything,” Bolin added.
The megabill will also make most states, except for Alaska and other states that won a carveout in the Senate version, chip in on food stamp benefit costs that the federal government has fully covered under the Supplemental Nutrition Assistance Program.
About 172,000 Mainers receive SNAP benefits, per the latest government estimates, and liberal interest groups found about 31,000 Mainers may lose their benefits under proposed eligibility changes in the bill. Gov. Janet Mills noted annual SNAP benefits in the state total $356 million.
The Senate version of Trump’s bill would make Maine pay 15 percent of SNAP benefit costs starting in 2028, or about $53 million annually, according to Mills’ office, and an added bump in covering SNAP administrative costs would put Maine on the hook for about $20 million a year.
In a June letter to Maine’s congressional delegation, the Democratic governor also said the Senate’s version will cause MaineCare to lose $5.9 billion over the next decade, with federal dollars making up $4.5 billion of that total.
BDN writer Marie Weidmayer contributed to this report.