The Devastating Consequences of ACA and Medicaid Cuts Are Now Here

And worse than we thought

Jodee, a midwestern friend replied, “Wait, what …why?”

Blue Cross Blue Shield Customer Care Agent: “Mayo is no longer in network and your costs will not be covered if you choose Mayo Clinic, but there are others to choose from.”

Jodee: “But I have a very specific and unique medical history and I only go to Mayo for that reason for the last thirty-five years. I can’t start over with another provider. I have tried that before and it lands me in situations receiving tests that are unnecessary and inappropriate treatments or worse, missing key issues.”

Jodee relayed this conversation regarding the sudden and abrupt removal of her two top healthcare providers recently due to the current administration cutting ACA subsidies.

On the heels of that conversation, came this one with my former colleague, Roberto.

Roberto has had a lifelong heart condition and has relied on Cleveland Clinic’s top-notch cardiac care to make sure he is maintaining his health and staying in front of his condition.

Last week he called to say hi and immediately launched into this “Idiotic administration is setting healthcare back 20 years.”

Now, important to note, Roberto happens to be a top expert in healthcare consulting and knows a thing or two about hospital systems, insurance and quality of care.

He went on to share, “I just got off the phone with my insurance agent. I had called him to ask why would any insurance provider take a top hospital system like Cleveland Clinic with outstanding outcomes, the highest quality of care and deeply respected for research, out of network?”

His agent was blunt, “Money.”

“This is how insurance companies are trying to ebb skyrocketing expenses because they are no longer going to receive ACA subsidies from the government. They are taking higher end hospitals and providers out of network, so they don’t have to reimburse them.”

Weeks before having those conversations, I received a call about two hospitals closing in the last six months with nine more to likely close within the next six months due to Medicaid and Medicare cuts last year.

• West Suburban Medical Center (Oak Park): Suspended all patient care and closed its emergency room in March 2026 due to a “financial crisis” linked to a year-long failure of its electronic medical records billing system and funding cuts.

• Weiss Memorial Hospital (Chicago - Uptown): Closed in August 2025 after losing Medicare and Medicaid funding, following a CMS termination notice regarding safety, nursing, and physical condition violations.

Additionally and very concerning for areas where there is minimal healthcare anyway, there are nine rural hospitals in Illinois, including Katherine Shaw Bethea Hospital (Dixon), OSF Sacred Heart Medical Center (Danville), and Richland Memorial Hospital (Olney), set to be closing within the year.

The impacts of these cuts are becoming incredibly real and quite devastating for everyone, regardless if you live in a rural, urban or suburban area, or are if you are on Medicaid or have private insurance.

Everyone’s costs are escalating and access is decreasing.

Insurance companies are tightening their provider networks, often narrowing them to exclude high-cost, high-end hospital systems, as they adjust to the expiration of enhanced Affordable Care Act (ACA) subsidies since end of 2025. With the enhanced subsidies expired, premiums are projected to more than double for many enrollees in 2026, forcing insurers to cut costs and narrow networks to maintain affordable plan options.

Be Aware: Key Ways Insurance Companies Are Reducing Access and Increasing Costs

Narrower Networks: To mitigate premium spikes driven by the subsidy loss, insurers are relying more on “narrow networks,” which exclude expensive providers to offer lower-cost plans.

Provider Financial Risk: The shift in ACA volumes and the move towards skimpier coverage are expected to cause high-end hospital systems to face significant financial strain, with some experts projecting a potential $32 billion loss in revenue for providers by the end of 2026.

Reduced Coverage Access: Hospitals in 12 states are at high risk of increased uncompensated care due to the combination of reduced subsidies and limited Medicaid expansion.

Non-Network Plans: Proposed 2027 rules are exploring allowing plans without traditional provider networks into the ACA exchanges, which would further remove the requirement for insurers to include high-end systems in their networks.

This shift is part of a broader reaction by insurers to an anticipated sicker, smaller, and more expensive patient pool in the ACA marketplace following the expiration of the temporary subsidies that was in place from 2021 through 2025.

Some Light Moving Forward and What We Can Do

First, if you have a pre-existing or ongoing condition where there are unique needs and your provider has been taken out of network, you can ask your insurance company for a temporary waiver to get around their new policies. Some folks are having success with this. Others are negotiating special rates. Regardless, demand they try to help you.

Secondly, make sure you let your Dem leaders as well as your congressperson know that one of the first three things to be done in January of 2027 with no exception or dawdling is to reverse ALL healthcare cuts from last year. And then address Medicare For All.

Thirdly, make your voice heard that we must impeach, convict and remove this president after we take control back. There cannot be another two years of this madness and deal with his path of constant destruction.

With that, keep fighting, keep charging and find some giggles this week,

M

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