Rhode Island’s nursing home residents would suffer if Congress cuts Medicaid, Magaziner says

Gregory Strong, a former business owner now living at the Bannister Center in Providence, told reporters about the impact federal Medicaid cuts could have on nursing facility residents like himself after a press conference held by U.S. Rep. Seth Magaziner on Feb. 28, 2025. “We’re able to stand up, most of us. But even the people that are bedridden wanna fight,” Strong said. (Photo by Alexander Castro/Rhode Island Current)

Gregory Strong used to install fiberglass insulation and vinyl siding, and even co-owned a business. But after an accident left him unable to walk and requiring use of a wheelchair, Strong now lives at a nursing home in Providence. 

Medicaid subsidizes Strong’s stay at the Bannister Center. He’s frightened, and more than a little upset, at recent talk that the program might suffer spending cuts at the federal level.

“We’re not a poor country,” Strong said. “We are a rich country, but we need to take care of ourselves first, and for this president to do this, I don’t believe this. This is worse than being in the 1800s.”

Strong shared his story and concerns with reporters after a press conference Friday afternoon, hosted by U.S. Rep. Seth Magaziner at the Bannister Center, the latest in Magaziner’s series of rallying cries against the Republican-controlled U.S. government. This time his target was the recent budget resolution passed in the U.S. House of Representatives that would deduct $880 billion from the House Energy and Commerce Committee in the next decade to help enact tax cuts and raise the national debt limit. 

Critics of the GOP spending plan, including Magaziner, say those cuts would most likely eviscerate Medicaid — the public insurance program under jurisdiction of Energy and Commerce, and which subsidizes about 65% of nursing home residents. Those Medicaid dollars keep people like Strong housed, and they also keep nursing homes in business.

Sweeping federal cuts could lead Rhode Island to lose $220 million in nursing home revenue, Magaziner said, which would in turn lead to facilities closing. It’s unlikely the state could tax its way out of the problem, he added. 

“The proposals that I’ve seen at the State House to increase taxes that may or may not go anywhere — I don’t think any of them would raise $500 million a year, right? Even the most liberal ones,” Magaziner said. “So, you know, there would really be no getting around cuts to services.”

John Gage, the president and CEO of the trade group Rhode Island Health Care Association, told the crowd of media and nursing home workers and residents that Medicaid is the primary payer for two-thirds of Rhode Islanders who live in nursing homes, accounting for about 5,000 people overall. That money helps pay for “basic activities of daily living, bathing, dressing, walking,” Gage said, many of which Medicare or private insurance does not cover. 

Even with Medicaid money, Gage said, “the average nursing home operates in the red.”

Jesse Martin, the executive vice president of SEIU 1199, the union which represents numerous health care workers in the state, said the cuts would be equally disastrous for the workforce.

“You have cuts of this magnitude, you’re talking about thousands of people losing their job,” Martin said. “You take beds out of the system that need to be there, and when you destabilize a healthcare system, which these cuts would do, there’s going to be a lot of shifting things.”

Concern in the State House

U.S. House Speaker Mike Johhnson told reporters on Feb. 24 that it was too early to speculate about the final outcome of the budget resolution. 

“Look, everybody needs to understand that the resolution is merely the starting point for the process,” Johnson was quoted in Politico. “So there’s nothing specific about Medicaid in the resolution. The legislation comes later, so this is the important first start.”

Magaziner conceded that the budget resolution was “just the first step in the process,” and might never come to pass. He also acknowledged that both Republican lawmakers and President Donald Trump have at least publicly disavowed severe cuts to Medicaid. The resolution passed in the U.S. House with a 217-215 vote, which Magaziner thought could be flipped by Republicans in swing districts. 

“We will have another opportunity to vote on the final budget, probably in May or April, and that will be our opportunity to kill these Medicaid cuts once and for all,” Magaziner said. “All we need to do is find one or two Republican members of the House who will flip their votes and come over and join us to prevent these cuts from happening. We already got one this week who flipped. We just need one or two more. That’s it.”

Rhode Island’s state GOP lawmakers have expressed their own desire to limit Medicaid in this year’s legislative session. But Rhode Island’s Medicaid program, which accounted for $3.9 billion in medical expenditures in fiscal year 2023, has wider eligibility compared to some states. The state GOP wants to more closely align the program’s spending with “the most vulnerable populations, the disabled and the elderly,” according to a recent House Minority Caucus Legislative Agenda, as a means of sustaining the program long term and eventually reinvesting that money into home and community-based care for the elderly and people with disabilities.

When it began in 1965, Medicaid was a public insurance program designed for low-income people. Over the years, it has evolved toward more complex models that are managed differently state by state.  

“You will sometimes hear Medicaid directors say if you have seen one Medicaid program, you have only seen one Medicaid program,” Kristin Sousa, the director of Rhode Island’s Medicaid program, told state senators Tuesday during a committee meeting. Sousa was at the State House to provide updates on the status of Rhode Island’s Medicaid programming.

When asked by senators to describe her worries, Sousa said, “The biggest concern is protecting the beneficiaries, and then not very far from that is the fiscal impact that the changes could potentially have on the state. And I think it’s hard to talk about that right now because we don’t know what will happen.”

Possible Medicaid cuts also have leaders in the state’s life science industry concerned. At a Feb. 20 meeting of the Rhode Island Life Science Hub, a discussion about the possible impact of National Institutes of Health (NIH) reimbursement cuts for research led to a discussion about Medicaid. Potential cuts to Medicaid could pose a more colossal problem, said Dr. Michael Wagner, the CEO of the state’s second largest health care network, Care New England. 

Wagner told the life science board members he had recently talked with Magaziner about the severity of different health care-related cuts that might come under the Trump administration. Wagner said he told Magaziner: “If you think of the NIH cuts on a scale of one to 100 as being a 15 or 20, Medicaid is a 70 to 80 in terms of impact.”

If bundled into the $880 billion spending cut package, Wagner said, “That would be devastating. And Medicaid also already pays us lower than all of the other payers.” 

But, said Wagner, about a third of all patients in the state receive Medicaid benefits.There were about 389,000 Rhode Islanders who received full medical benefits via the program in fiscal year 2023, according to a state presentation. Those numbers include people like Strong, who said he wouldn’t be on public assistance if it were his choice to make.   

“It’s not like we want to get paid. We just want help so that we can survive,” Strong said of himself and his fellow residents on Medicaid. “If it wasn’t the way we were, we probably would still be working. I worked like hell, and I had an accident. Now, they’re gonna tell me that they’re gonna forget me?”

Strong is an active resident in the nursing home and said he still has “a lot of fight” in him.

 “We’re able to stand up, most of us,” said Strong. “But even the people that are bedridden wanna fight.”