The Budget Reconciliation Bill's Financial Impact on Children’s Hospitals

The budget reconciliation legislation will have a devastating effect on the financial viability of America’s children’s hospitals.

Published Sep. 04, 2025|
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On July 4, President Trump signed reconciliation legislation, H.R. 1, which includes numerous actions to reduce federal Medicaid spending through new restrictions on Medicaid eligibility and coverage rules, payments, and non-federal share financing. The attached report outlines the bill’s financial impact on children’s hospitals across the U.S. The results show the changes to Medicaid will indelibly harm children.

The budget reconciliation bill includes policies that will reduce federal Medicaid spending by restricting Medicaid eligibility and coverage rules, payments, and non-federal share financing. The CHA-commissioned report by Manatt Health models the financial impact of proposed changes to state-directed payments (SDPs) and provider taxes based on survey responses from 60 children’s hospitals across sixteen states.

The budget reconciliation bill's restrictions on provider taxes and SDPs will limit states’ ability to finance enhanced Medicaid payments. This will have a devasting impact children’s hospitals’ ability to sustain and promote access to care for children and their families in the Medicaid program.

Read the full report.

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