It’s been nearly a month since President Trump signed the so-called “One Big Beautiful Bill” into law. With looming steep cuts to Medicaid wrapped in the sweeping piece of legislation, Bloomington-Normal health care providers are still trying to pave a path forward or even figure out what the cuts mean for them.
The nonpartisan Congressional Budget Office projected policy changes to Medicaid and Affordable Care Act eligibility requirements will result in a $1 trillion spending cut over the next decade—and some 500,000 Illinoisans becoming newly uninsured. That’s left hospital officials reeling—with some saying they’ll have to make tough decisions about laying off staff, cutting back services or closing altogether—and others, like Normal’s free Community Healthcare Clinic, bracing for an uptick in patients.
Included among the changes are policy updates to work requirements, which Republican lawmakers including U.S. Rep. Darin LaHood, R-Dunlap, said are needed to cut spending and avoid abuse of the federal social safety net. The new guidelines primarily roll back a COVID-era Medicaid expansion that made nondisabled, working-age adults eligible without having to prove they were working or actively seeking a job.
A 2025 Georgetown University analysis indicated 14.3% of McLean County residents in 2023 were receiving Medicaid benefits, slightly below the statewide average. Local health care providers say most adults on Medicaid are already working.
How Twin City providers are responding—or not
The Twin Cities' two major health care providers are staying relatively quiet about their plans. Carle and OSF HealthCare declined to speak with WGLT directly about the issue—or how they intend to handle it.
Carle said the impact on hospitals and health systems across the nation “will be substantial.”
“With potentially millions of individuals losing coverage across the country over the next decade, challenges will be plentiful,” the statement said.
“As we actively assess how these legislative changes may affect our daily operations and identify any necessary adjustments, we are unwavering in our commitment to be a trusted source of high-quality care across the region in both urban and rural communities.”
OSF HealthCare similarly said they “remain steadfast in providing the best care possible,” pointing out the “many unknowns of how the changes will ultimately affect hospitals and how and when the provisions will be implemented.”
Democrats in Congress, including both of Illinois’ senators and U.S. Rep. Eric Sorensen, D-Moline, broadly criticized the bill’s potential impact on rural hospitals. A $50 billion carve out for rural health care got some Republicans over the line to pass the bill almost entirely along party lines.
OSF HealthCare said the rural hospital provision is something they’ll be “keeping an eye on.” Just under 25% of all OSF patient care is covered by Medicaid.
In addition to Carle BroMenn Medical Center and several outpatient and specialty care clinics operated by Carle in Bloomington-Normal, that medical group also runs the only trauma center in Woodford County. They declined to comment on if or how cuts to Medicaid would impact Carle Eureka specifically.
Others from within the Illinois Critical Access Hospital Network, which has been a vocal opponent of the cuts—including Gibson Area Hospital in Gibson City and Warner Hospital in Clinton—did not reply to requests for an interview.
Hopedale Medical Center responded to an email from WGLT, saying the Medicaid cuts are unlikely to affect them much. Chief Operating Officer Emily Whitson said their Medicaid payer mix is just 2%.
Illinois can’t fill the gap
How providers respond depends in large part on Illinois’ ability to shoulder the federal cuts. Illinois Gov. JB Pritzker has expressed unwavering support for providers and recipients, simultaneously forecasting the state’s inability to fill the financial the gap.
Two potential consequences at the state level could be rolling back state Medicaid expansions. There is precedent for such a move. Illinois recently stopped Medicaid coverage for some undocumented immigrants. The state pulled benefits for adults, saying demand [and cost] for the program far exceeded expectations.
Another possibility is to change the reimbursement rate for providers—meaning they’ll get less money per billable hour of services.
Hopedale Medical Center COO Emily Whitson said a cut to the current pay rate “wouldn't be material for us in any case,” given the small number of their patients on Medicaid. McLean County Nursing Homes administrator Tim Wiley was less dismissive of the potential impact on nursing homes, but said at this point a change to reimbursement is “pure speculation.”
A ripple effect
Chestnut Health Systems CEO Dave Sharar said the changes in work requirements “throws a lot of bureaucracy at the working poor,” which Medicaid advocates say will inadvertently throw people off their insurance.
“Many of our clients and patients don’t come to an appointment with a payroll report,” he said. “There’s churn in this work, too. People change jobs, lose jobs… unfortunately some of those people will fall through the cracks and become uninsured.”
There’s also the question of if or how the state will be bogged down by that bureaucracy.
“I don’t believe the state’s in a great position with their IT systems to figure this out,” Sharar said.
“They barely pay as it is,” Whitson said, “which is why we aren't in network with ACA programs.”
Specialty providers whose services may be indirectly impacted by Medicaid cuts have been equally wary of making predictions. One of them is Lifelong Access, whose youth health care clinic planned for the Pantagraph Building could be in jeopardy if partner organizations relying on Medicaid, like Chestnut Health Systems, are handicapped by the cuts.
New CEO Karl Kopp initially declined an interview. A spokesperson told WGLT, “We would like to wait until we have more updates to be able to share with you and our community.”
Kopp later spoke to WGLT at a Bloomington Planning Commission meeting proposing historic landmark status for the Pantagraph Building, echoing his agency’s message by saying “it’s too early to know” how the cuts will impact occupational therapy and other services for people with disabilities.
Sharar said, for now, they’re still planning on being part of the project. But there’s a lot on the line, with nearly 70% of patients at their family health clinic receiving Medicaid benefits.
“We’re still in for now although we just don’t know how this is all going to shake out,” he said. “We haven’t even talked about how Medicaid funding contributes to an economy.”
There's the potential for consolidation and lost jobs, for example. And Chestnut, Carle and OSF are big employers in Bloomington-Normal. There's also a strain on law enforcement, paramedics and social service agencies when people aren't getting preventative care.
“Other systems will be impacted by this,” Sharar said.
