PALM BEACH COUNTY, Fla. — A sweeping and controversial health care overhaul—nicknamed the “big beautiful bill”—is now just one signature away from becoming law.
The legislation, which passed the House 218–214 Thursday, includes $1.1 trillion in health care cuts, with the vast majority targeting Medicaid. It now heads to President Donald Trump’s desk.
WATCH: Local health care advocates worry about what comes next
While House Republicans celebrated its passage, not everyone agrees it’s cause for relief.
“I call it one big, ugly bill,” said Rep. Lois Frankel, D–Palm Beach County, one of the 214 lawmakers who voted against it. “Losing your health care insurance is not a relief.”
Frankel and other critics warn the bill could strip Medicaid coverage from 1 in 10 Americans. In Florida’s five-county region, where nearly half a million people rely on Medicaid, state data we uncovered suggests close to 50,000 residents could lose access to care.
“We’re concerned,” said Karen Harwood of Palm Beach County Medical Society Services.
Harwood, the director of Community Services, told WPTV more than 180,000 people in the region are already uninsured.
"We’re concerned about the number of uninsured patients increasing," said Harwood. "When people are uninsured, they’re less likely to see doctors, less likely to seek preventative care, less likely to go to the emergency room in a crisis, so yeah, we’re concerned."
Mary Mayhew, president and CEO of the Florida Hospital Association, said rural and for-profit hospitals are especially vulnerable. Many rely heavily on Medicaid reimbursements to keep patient care running.
“We have rural hospitals today that are financially stressed. This will only compound that situation,” Mayhew said.“It is going to affect access to health care services in our rural communities.”
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A recent study from the Center for Patient Quality and Healthcare Reform found about 10 Florida hospitals are already at risk of shutting down, with two hospitals at imminent risk.
The concern, however, isn’t limited to rural facilities.
At an emergency meeting Wednesday, CEOs from major hospitals across Palm Beach County urged local commissioners to prepare for the financial strain.
“Today, I am standing before you to represent hospitals north to south — east to west—” said Jason Kimbrell, CEO of HCA Florida Palms West.
Kimbrell and other hospital leaders urged Palm Beach County commissioners to consider adopting a hospital provider tax—a funding tool that allows governments to collect fees from hospitals in order to draw down additional federal Medicaid dollars.
Under the program, every dollar raised by the state is matched by the federal government through the Federal Medical Assistance Percentage, or FMAP.
While hospitals pay into the system, many receive more in return through higher Medicaid reimbursements. Hospital CEOs said if the county opts in now, local hospitals could be grandfathered in—protecting them from deeper financial losses tied to the national health care overhaul.
“We also fear that [patients] will come to us sicker because they won’t want to get care right away," Don Chester of St. Mary’s Medical Center warned.
Frankel echoed those concerns, noting: “These were not rural hospitals, these were in our bigger cities... emergency rooms are going to pile up, and you’re going to see healthcare providers walk away.”
In an interview with investigative reporter Kate Hussey, Republican Congressman Mike Haridopolos of Brevard, Orange and Indian River counties defended the legislation, saying he pushed to protect the most vulnerable.
"The people who are on traditional Medicaid, they’re going to be protected. It’s one of the things I fought for to make sure if you're a senior in a nursing home, you're pregnant, a child in a low income family, nothing changes at all," said Haridopolos. "The odds are, you’re not going to lose Medicaid, we protected those because they are the most vulnerable in our society."
Haridopolos also pointed to $50 billion in funding earmarked for rural hospital support and encouraged concerned constituents to contact his office directly.
"We want to be—just as you said, Kate— really transparent," said Haridopolos. "I want to make sure I'm answering the tough questions and the fears that are out there, I understand if people are concerned."
Haridopolos also pointed to the bill's additional funding for border security and what he said will be historic tax relief.
"I think the best part about this bill is that we made promises last November and we backed up those promises," said Haridopolos.
WPTV also reached out to all hospital networks in our area. Most declined to comment on the issue, however, many pointed out that for-profit hospitals will be most impacted by the cuts.
Amid social media rumors that Lakeside Medical Center in Belle Glade is at risk of closing, the Health Care District of Palm Beach County told WPTV that claim is false and released the following statement:
Since 1988, the Health Care District of Palm Beach County has proudly served as the health care safety net for one of Florida’s most populous counties. For nearly four decades, we’ve evolved to meet the unique needs of our communities—providing comprehensive, turnkey services that now include a diverse and wide-range of operations, including: the county’s Trauma Hawk air ambulances, nine federally qualified health centers, a skilled nursing facility, school health in more than 170 schools, and Lakeside Medical Center - Florida’s only rural teaching hospital.
Rural hospitals are essential lifelines for the communities they serve. While many have closed nationwide over the past 20 years, the Health Care District has remained committed to strengthening care in the Glades region through Lakeside Medical Center. To support this mission, we welcomed Tampa General Hospital as a partner in February 2025 to help enhance Lakeside’s services and the overall wellness of the rural communities we serve. Together, we are currently assessing local health needs and using that data to drive operational growth and expand care.
Transparency and engagement with the community has been at the forefront of this partnership since day 1. Recently, claims have circulated suggesting that Lakeside Medical Center may be at risk of closure due to proposed federal policy changes. These claims are false. The District continues to monitor policy changes at all levels of government, and remains committed to sustaining and improving access to quality, affordable health care—especially in underserved areas.
Palm Beach County commissioners say they plan to hold another meeting with hospital leaders in the coming weeks.
