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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.”

Not that I disagree with this assessment but has the expected process of this catastrophe been explicated anywhere?

But will the effect of the cuts be felt immediately? I can’t get a straight answer if the money disappears immediately or closer to ‘28 and if that makes any difference.

Hospitals plan budgeting in multi year stretches, and knowing that your overall revenue will shrink over the next 5 years without any expected replacement means layoffs, service cuts and closures. Everyone is gonna get hurt but red states will suffer even more without intervention which is unlikely.