Destruction of Rural Medical Care Begins in 2027
How HR1, the so-called “Big Beautiful Bill,” will gut rural healthcare after the midterm election.
By Dakota Hendricks
Panelist Becky Ludwick, PJ Dan and Doug Manion
PIKE- As part of the national Seven Days in June movement, current Milford Borough Mayor Candace Mahala and former Mayor Sean Strub hosted a local town hall panel at the Lehman Town Center to educate the public on how the damages from the “Big Beautiful Bill” will impact the local community and severely hamper medical care.
The panel consisted of local politicians and experts in the medical field, as well as local volunteers. Collectively, they painted a dire warning of funding shortfalls, crumbling rural care, private equity vulnerabilities, and higher taxes.
In a two hour session, each panelist gave a presentation before the public questioned the group. The panel began with Becky Ludwick, the Vice President of Public Policy for the Pennsylvania Partnerships For Children. Ludwick spoke extensively about the data the PA Partnerships has been collecting about the impact of HR1 across PA. According to Ludwick, 36% of children in Pike are covered by Medicaid and the County will lose $228.2 million in funding because of these cuts by 2034. Cuts to SNAP and CHIP are estimated to be 46 less meals a month, or 1.5 less meals a day per person.
HR1 modifies the Federal State split for Medicaid funding from 50-50 to 25% federal, 75% State, creating a large gap that will be impossible to fill under the current budget constraints without raising taxes.
Dr. Doug Manion, a specialist in infectious diseases, spoke about the “deplorable state” of US medical care in general. The US leads the world in highest healthcare costs and has the lowest returns, the lowest life expectancy, as well as the highest death rate by preventable means. Manion showed several graphs indicating PA is the 9th best health care state in the US currently.
Graph and chart showing the US has an unusually low life expectancy for money spent in healthcare and an extremely high mortality rate for preventable deaths.
PA State Representative Tara Probst spoke about the significantly higher cost of living, medical care, and housing and how this stems from greed and private equity. Probst said she is old enough to remember a time when minimum wage workers could afford rent, where a modest job could afford a family home, a car and health insurance. Probst made it clear she views private equity and corporate greed as the main cause of the American Dream being priced out of existence for most.
PA State Representative Tara Probst spoke about her experiences growing up and how vastly more expensive it is to live now.
Pike County Commissioner Christa Caceres highlighted the many programs available for Pike residents through the county and state. Pike County exists in a severe medical desert, with only one pediatrician, no emergency care, no hospital, no urgent care, no maternity care, no women’s health care, and intermittent EMS coverage. The Commissioners have been working with municipalities to bolster funding for EMS coverage and with Northwell Health to open two small medical care locations and are working to bring a micro hospital into the area, a small ten bed facility.
Pike County Ecumenical Food Pantry volunteer Lisa Krenkel spoke about the shortfalls of serving the community. She said the food pantry relies 80% on donations to support the community, and it has not been enough. The food pantry is serving 100 families a week, and recently hit a tragic new record of the highest number of families served in one day.
PJ Dan spoke at length about how the changes in HR1 will impact facilities receiving funding and the many ways the bill makes people ineligible for coverage and assistance. Pike County is in 3rd place for the number of residents being kicked off assistance based on projected impact.
Robin Skibber, who ran the Area Agency on Aging for 22 years, spoke at length about how these cuts will impact the elderly in the area and how preventive health care and the socialization of the elderly is highly important for healthy elderly people. Pike County has a sizable elderly population, with many elder care facilities that will be impacted by these cuts. She also highlighted how these financial cuts will result in worse quality foods moving through the support system for SNAP recipients.
Why do these cuts matter to people not on assistance?
There will still be dire consequences for those who are not on Medicaid, Medicare, SNAP or CHIP. As people lose coverage, they will flock to available emergency care facilities, overwhelming staff and resulting in more bills not being paid. Medical facilities that struggled before will receive even less funding and face more patients who cannot pay, so non-profit facilities will close or be forced to move toward for-profit models. Manion said the for profit hospitals and private equity controlled medical care come with an 18-23% increase in cost for patients that can pay and have imposed strict limits on time spent on each patient to between 13-18 minutes. There are 16 hospitals in PA that are expected to close because of these changes.
Former Delaware Township Supervisor Jane Neufeld said that during her time at the Delaware Township Ambulance, the ambulance received from 23- 27% on average, but as much as 40% of their funding, from Medicaid, and with cuts coming, ambulance coverage may once again be struggling. The price of emergency vehicles has exploded in recent years. Neufeld said that a fire truck is now around $1 million and an ambulance is $3.5 million.
In an environment where rural areas cannot pay, are losing funding assistance, and medical facilities struggle to stay afloat, Caceres urges locals to use the facilities in the area to help keep them afloat. Caceres said the lone women’s health center associated with Wayne Memorial closed due to lack of patients as well as expenses and she said she is not certain the facility will reopen, in contrast to Commissioner Ron Schmalzle’s claims from last month that the facility would reopen near Hemlock Farms.
All panelists spoke about the dire impact of HR1 and how the longer the bill is in place, the worse things will get for the community, as problems compound and new provisions come in place. The situation will get progressively worse until everything in the bill is implemented by 2034.
The panelists and members of the audience encouraged people to vote. Much of the bill can be repealed if there is a shift in government away from the Republicans who passed the bill. The panelists also encouraged the continued use of social media to spread the word about the impact of this bill on the community, those in need, and how badly it will impact the people who are fortunate enough not to need assistance.
For more information and helpful maps and graphs: https://www.papartnerships.org/hr1-mapping-the-cuts/projected-total-snap-and-medicaid-funding-loss-by-2034-by-county/
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