Medicaid for now, but what about later?
Firelands CEO Jeremy Normington-Slay worried long-term cuts still loom
SANDUSKY — The CEO of Firelands Health Systems on Thursday gave a mixed review of the federal legislation dubbed the “Big Beautiful Bill," suggesting it might bring some short-term Medicaid relief but warning that long-term reductions could pose serious problems for local healthcare providers.
Jeremy Normington-Slay said the bill includes several funding mechanisms that benefit Ohio hospitals, including a rural health fund and changes to the state’s Hospital Franchise Fee. While he's hopeful about the immediate impact, he also cautioned that some of these provisions are scheduled to decrease beginning in 2028.
"Yes, there are Medicaid changes in the legislation and we are watching those carefully," Normington-Slay said. "Still a lot in flux and we do not know the immediate impact."
He pointed to specific programs in the bill that may help offset existing deficits:
The Hospital Franchise Fee, which supports most Ohio hospitals
A Southern Rural Hospital Tax, aimed at hospitals referenced in a recent letter by Sen. Jon Husted
State Directed Payment Programs, which help a smaller number of hospitals
A new $50 billion national rural health fund expected to benefit rural Ohio providers
But his optimism is tempered by financial realities.
“Nearly 50% of Ohio hospitals are still operating in the red,” Normington-Slay said. “Current Medicaid rates only pay a fraction of the cost of care.”
Can we talk
Firelands and other hospitals have been in close contact with lawmakers, including direct meetings with U.S. Sen. Jon Husted, U.S. Rep. Marcy Kaptur, state Sen. Theresa Gavarone and state Rep. D.J. Swearingen.
Normington-Slay’s comments follow a joint press release this week from U.S. Sen. Jon Husted and U.S. Sen. Bernie Moreno, celebrating the Senate’s passage of the bill and highlighting $1.3 billion in Medicaid-related funding directed to Ohio’s rural hospitals.
In a thank-you letter included in the release, executives from four larger Ohio health systems praised the senators for their “tireless work behind the scenes.” The senators described the legislation as a major win for rural healthcare.
Normington-Slay, while acknowledging the support, struck a more measured tone: “We will need to see how it all shakes out with the final legislation and how it is implemented over the next few months.”
He emphasized that despite the headline numbers, much of the impact remains to be determined, especially beyond 2028, when some funding mechanisms begin to wind down.
“It’s encouraging, but the real test will be what happens next.”
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