Oklahoma has received a score of 49th in the nation for its health care in 2025, and with projected funding cuts to Medicaid, local providers project loss of services.

The top scores given by The Commonwealth Fund ranked Massachusetts, Hawaii, New Hampshire, Rhode Island, and the District of Columbia at the top of the list.

“[This is] based on 50 measures of health care access and affordability, prevention and treatment, avoidable hospital use and costs, health outcomes and healthy behaviors, income disparity, and equity,” states the article titled, “2025 Scorecard on State Health System Performance, Fragile Progress, Continuing Disparities,” published on the Commonwealth Fund site.

The scorecard rated infant mortality, vaccination rates, racial disparities in premature and avoidable infant deaths and avoidable mortality in African Americans, to name a few.

A recommendation of the report was, “Targeted, coordinated federal and state policies are needed to raise health system performance across the nation.”

An article on factcheck.org, “The CBO Breakdown on Medicaid Losses, Increase in Uninsured,” published July 11, breaks down the facts of how the “Big Beautiful Bill” passed by Congress will affect the number of folks insured through Medicaid, which will have direct impacts on rural hospitals.

“The Congressional Budget Office estimated the House version of the One Big Beautiful Bill Act would reduce Medicaid enrollment and cause millions of people to become uninsured by 2034,” states the article. “It didn’t say that ‘5 million’ of the people who are ‘going to lose insurance’ would have ‘other insurance’ so ‘they’re still insured,’ as National Economic Council Director Kevin Hassett misleadingly claimed.”

James Berry, CEO of Northeastern Health System, said if eligibility for Oklahomans is cut due to work requirements, for instance, the hospital would experience an increase in emergency department visits.

“…generally sicker patients … would be hospitalized; and more dollars [would be] going to collections or bad debt,” Berry said. “Since Medicaid is a state and federal funding match, what the feds impose would reduce the dollars flowing into the state.”

Berry said this is complicated by State Question 802, which mandates Oklahoma to expand Medicaid eligibility to Oklahomans who earn a living at or below 133% of the federal poverty level.

The charts on medicaidplanningassistance.org/federal-poverty-guidelines, show that 133% for a household of one would mean an income of $20,815; for a household of two it is $28,130; and for a family of five it is $50,075.

“If they cut a particular program, we might reduce our offerings in the service linespace or shut it down,” Berry said.

If general funding is cut, Berry said, several things could happen. NHS could reduce the cost of care, hopefully without laying off people. He said this would be a last resort, as far as cost cutting.

“I believe convenience should be sacrificed before quality and certainly before safety,” Berry said. “We would do everything in our power to continue to meet our patients’ expectations, focusing on the provision of safe, high-quality care.”

He said this might include changing the level of support service staff available. Another way would be to gradually reduce the care available currently in favor of basic or core hospital services.

Chief Executive Strategy Officer Brian Woodliff, for NHS, recently released a statement about the loss of Stilwell Memorial Hospital. He said NHS is committed to preserving rural health care access in the region and that the Stilwell hospital, which was scheduled to close June 20, played a vital role in Adair County.

He stated in the press release that NHS is equipped to assist with a “robust infrastructure” that includes both air and ground ambulance services, as well as comprehensive specialty care capabilities such as cardiology, oncology, stroke, neurosurgery, pulmonology, nephrology, rheumatology, orthopedics and spine care.

“It is NHS’ ongoing mission to expand access to quality health care across rural Oklahoma and stabilize hospitals that are the cornerstone of their communities,” Woodliff said.

Woodliff addressed the impact that the proposed Medicaid cuts would have on hospitals.

“The Senate version proposed slashing funding for Medicaid to help pay for the spending priorities and tax cuts,” Woodliff said. “[U.S. Sen.] Josh Hawley, [R-Missouri] intimated there is new language that prolongs the provider tax framework and provides $25 billion to support Medicaid rural providers from 2028 to 2032.”

Hawley believes these measures will maintain the baseline Medicaid reimbursement for the next 4 to 10 years, Woodliff said.

Woodliff offered quoted stats from Oklahoma Hospital Association’s research on the bill and the impact on Oklahoma.

“[This includes] 15,000-18,000 lost health care jobs; as many as 300,000 fewer insured citizens, including fewer covered moms, babies and nursing home patients; and $800 million in annual wages lost,” Woodliff said.

The initial annual reduction estimate from NHS Tahlequah is $4,720,656, according to the Cambridge Institute, which advises OHA.

“NHS is a nonprofit public trust that provides community benefit through a wide range of services that do not have a positive financial return,” Woodliff said. “NHS would subsidize some of its service lines or the patients would have to seek care in a metropolitan area or go without access.”