A reduction in the provider tax that funds the state share of Medicaid expansion could spell trouble for hospitals that rely on it.

U.S. House of Representatives Speaker Mike Johnson looks at U.S. President Donald Trump signing the sweeping spending and tax legislation, known as the "One Big Beautiful Bill Act," to mark Independence Day, at the White House in Washington, D.C., U.S., July 4, 2025.

When Michelle Lawrence heard about Medicaid cuts in the Republican tax and spending bill, it felt like “a punch to the gut.”