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Spoke with someone who works with a public hospital system. His assessment of the effects of the GOP spending bill: “I think this is going to be a very apparent catastrophe, very quickly.”

Provider tax is immediate but cuts are phased in through 2030. But that doesn't matter b.c. hospitals are collateralizing their debt based on projected Medicaid reimbursement going out 10yrs. The debt will be called in & hospitals will collapse immediately even with cuts several years away.