WHEREAS:
The One Big Beautiful Bill Act (OBBBA), signed into law by President Donald Trump, puts our nation’s entire health system in grave danger. The OBBBA cut federal spending on health care by more than $1 trillion over its first decade — including more than $900 billion from Medicaid — and is expected to result in 10 million more people being uninsured. The law also deliberately let the Affordable Care Act’s (ACA) enhanced premium subsidies expire, which is projected to result in more than 4 million people becoming uninsured; and
WHEREAS:
Beyond their enormous harm to individuals, the coverage losses stemming from the OBBBA and the failure to extend enhanced ACA subsidies will have immense financial consequences for health care providers, especially community hospitals, as rates of uncompensated care increase; and
WHEREAS:
Even before the OBBBA’s cuts hit, many hospitals have been under threat, and some have closed all or some of their facilities, including some that employ AFSCME members, such as Christ Hospital in Jersey City, N.J., which closed its emergency department in March 2026, and Insight Hospital and Medical Center Trumbull in Warren, Ohio, and Insight Rehabilitation Hospital Hillside in Howland, Ohio, which closed suddenly in March 2025, stemming from the harm caused by private equity; and
WHEREAS:
By one estimate, 446 hospitals across the U.S., primarily critical safety-net hospitals in urban and rural America, are at heightened risk of closure or shutting down service lines in the wake of the OBBBA’s Medicaid cuts, placing the health and well-being of nearby residents in jeopardy by significantly reducing access to quality health care services; and
WHEREAS:
The loss of these hospitals would force patients to travel greater distances, endure longer waiting times for emergency and inpatient care, or in many cases, forgo necessary medical treatment altogether; and
WHEREAS:
Even in stable economic times, periodic hospital closures are highly disruptive for workers and entire communities. Studies have consistently shown that when a community hospital closes, surrounding hospitals become overcrowded, placing additional strain on the health care workers, reducing access to timely care and increasing the risk of adverse patient outcomes, including higher mortality rates; and
WHEREAS:
Strong community hospitals are essential economic anchors that support public health, create family-sustaining union jobs, strengthen local businesses and improve the overall quality of life. The closure of any hospital would eliminate hundreds or even thousands of jobs, devastating working families and the regional economy. The OBBBA’s cuts to Medicaid are projected to eliminate nearly 500,000 health care jobs across the U.S. and result in nearly 500,000 more non-health care jobs being lost by 2029.
THEREFORE BE IT RESOLVED:
That AFSCME calls upon all governors, state legislatures and local officials to take steps to prevent the closure of financially distressed hospitals within their jurisdiction and minimize the harms stemming from the OBBBA, as well as to strengthen the long-term financial stability of health care facilities in order to protect patient access to high-quality care and preserve health care jobs; and
BE IT FURTHER RESOLVED:
That AFSCME will advocate for Congress to reverse the harmful cuts to health care in the OBBBA and to reinstate the ACA’s enhanced premium tax credits. AFSCME will also advocate against additional harmful cuts to federal funding for health care; and
BE IT FINALLY RESOLVED:
That AFSCME calls upon state policymakers to scrutinize the actions of health care systems and hold them accountable for the local impacts of their decisions. All acute-care hospitals threatening closure should be required to provide unions, employees, elected officials and members of the community with a comprehensive closure plan and supporting documentation necessary to evaluate the impact of such action, including timely notification to patients, staff and all appropriate governmental agencies.
SUBMITTED BY:
Craig Ford, President and Delegate
Charmaine Morales, Secretary-Treasurer and Delegate
NUHHCE/AFSCME Local 1199
Pennsylvania