45 hospital systems have announced job cuts this year

What you probably already know: Dozens of hospitals across the United States are grappling with financial challenges impacting health care workers at all levels. Forty-five hospital systems have announced reductions in their workforces or jobs since January. One of the Southeast’s largest teaching and trauma care hospital systems, Vanderbilt University Medical Center, recently announced plans to lay off up to 650 employees, primarily those working in research and administration (approximately 2% of its total workforce), in an effort to lower operating costs by more than $300 million. Providence, the largest health care provider in Washington, launched a restructuring plan this month that will impact 600 full-time positions across seven states, including leadership and patient-care roles.

Why? Vanderbilt University Medical Center said its cuts are “in response to the impact of budgetary actions in Washington, D.C., related to government-sponsored research and patient care.” Research institutions nationwide are reacting to the Trump administration’s proposed cuts to federal medical research funding. Hundreds of National Institutes of Health (NIH) research grants have already been terminated, and President Trump’s budget proposes cutting $18 billion from the NIH next year to curb what the White House refers to as an obsession with DEI and COVID-19 and focus on “restoring the Gold Standard of Science — not ideological activism.” Providence cited proposed cuts to Medicaid and Medicare, among other factors. The House’s recently approved domestic policy bill includes big changes to Medicaid estimated to reduce spending by $625 billion and push 7.6 million Americans off the health insurance program over the next decade. The bill includes a provision that would freeze the provider tax rate, a state-imposed fee on health care providers that states use to collect more federal matching funds for Medicaid spending.

What it means: Reductions in hospital workforces will likely impact a disproportionate number of women, who held 8 in 10 health care positions as of 2022. The House-proposed Medicaid cuts could lead to the deaths of over 16,600 people who can no longer afford care, and cause 380,270 women to skip getting mammograms, according to a new study published in the Annals of Internal Medicine. Limiting provider taxes would likely lead to funding shortfalls that states would need to offset by cutting other services or raising other taxes. A large portion of the money raised through provider taxes supports rural hospitals, which often serve a higher share of Medicaid patients and would be left to absorb care costs for uninsured people who can’t afford their medical bills. Many rural hospitals have already folded under financial strains or are barely staying afloat and limiting their services. Meanwhile, cuts to biomedical research disrupt ongoing clinical trials and delay the development of new drugs and therapies.

What happens next: Last week, a federal judge struck down Trump administration orders that led to the cancellation of hundreds of NIH research grants linked to topics like diversity, gender identity, and vaccines. U.S. District Judge William Young ruled the terminations were illegal because they represented “racial discrimination and discrimination against America’s LGBTQ community,” and ordered their immediate reinstatement. Trump officials are expected to appeal the ruling. Meanwhile, the House’s spending bill is working its way through the Senate, which has proposed even deeper cuts to Medicaid by gradually reducing states’ provider tax rate over time. Senate Republicans have reportedly floated the inclusion of a fund to help rural hospitals in the legislation. Federal lawmakers aim to deliver the spending bill to the president’s desk by July 4.