By Jim Kaufman, president and CEO, West Virginia Hospital Association
President Trump enacted the One Big Beautiful Bill Act (OBBBA) July 4, 2025, creating sweeping policy changes that will significantly affect West Virginia’s healthcare system.
This legislation contains multiple healthcare provisions that will reshape Medicaid enrollment and funding across the state. With the bill’s passage, recent reports have suggested some rural hospitals could close nationwide, including in West Virginia.
Factors vary greatly depending on the region, but healthcare leaders here in West Virginia are committed to working with communities and stakeholders to explore all available options for maintaining quality access to essential medical services – even as the proposed Medicaid cuts would eventually take away more than $1 billion in funding from the state’s hospitals.
The Medicaid cuts are postponed until 2028, and that provides some time and opportunity to make changes.
Congress has established the Rural Health Transformation Fund (Fund) as part of the OBBBA, creating dedicated resources specifically designed to strengthen rural healthcare systems like ours.
While the Fund represents an important federal investment in rural healthcare infrastructure, it alone cannot fully offset the projected Medicaid funding reductions. Success will require a comprehensive approach combining federal resources, state innovation and community partnerships.
That’s why West Virginia hospitals are enthusiastic about partnering with Governor Morrisey and the West Virginia Legislature to leverage federal investments in creative ways. Together, we’re exploring how these funds can advance cutting-edge medical technology, develop a highly skilled healthcare workforce, and expand access to quality care throughout our communities.
This extended timeline allows us to plan strategically. But we have to start now.
Hospital leadership teams are analyzing how OBBBA funding reductions will affect their budgets, services and planned investments. Despite the uncertainty surrounding these cuts and their inevitable impact, leaders are working diligently to maintain their hospitals’ ability to serve their communities – both now and in the future.
However, they need stable regulations and funding. Predictability is critical when three-quarters of patients served by West Virginia hospitals rely on Medicare, Medicaid and PEIA coverage. Any modifications to these programs will ripple throughout entire communities. Healthcare certainly will evolve with advancing technology, but our healthcare systems need consistent support to successfully navigate these changes.
The delay in cuts also gives Congress time to modify and revise the legislation – to reduce the chances rural communities lose hospital access.
OBBA presents real concerns for our hospitals and their 54,000 dedicated employees. But they remain committed to adapting and innovating. Their mission is and will continue to be making sure every community receives the quality care they deserve.
