LANE COUNTY – PeaceHealth is bracing for a significant shift in healthcare in Lane County, anticipating that the recent enactment of “H.R. 1” could leave approximately 25,000 local residents without health insurance.
Changes to healthcare have been a concern among healthcare officials and residents since the signing and implementation of H.R. 1, also known as the One Big Beautiful Bill Act.
H.R. 1 introduces significant changes to Medicaid and Medicare. Medicaid is a joint federal-state program that provides health coverage to eligible low-income Americans. Medicare is a federal health insurance program primarily for folks 65 and older.
The changes to healthcare have led to increased uninsured rates and reduced access for millions of people across the nation, including rural Lane County.
“There have been estimates that there are about 25,000 individuals who are current Medicaid recipients who may lose their insurance with the H.R. 1 implementation in 2027,” said Alicia Beymer, PeaceHealth’s chief administrative officer.
PeaceHealth hospitals, including RiverBend, Cottage Grove, and Florence facilities, and clinics across Lane County, see over 100,000 emergency department visits, 800,000 clinic visits, 26,000 inpatients, and perform 19,000 surgeries per year. More than 75% of those patients rely on Medicare or Medicaid.
PeaceHealth is reimbursed at 83 cents per dollar of cost for Medicare patients and 56 cents per dollar of cost for Medicaid patients. This loss of revenue could mean an increase in mandatory charity spending.
Beymer explained that charity spending is what PeaceHealth writes off for patients who come in for services and do not have health insurance.
“We are not able to bill or receive reimbursement for that, and that has been increasing steadily over the last few years,” she said.
H.R. 1, along with the elimination of Affordable Care Act Exchange credits, is anticipated to increase mandatory charity care spending by more than $20 million annually, on top of the $70 million currently budgeted, for a total of $90 million in charity care spending, according to PeaceHealth.
“As we look at Riverbend and PeaceHealth, because we are the largest employer and the largest Medicare medical provider in the community, we really want to be ready to serve as others may be cutting services around us, so we’re watching that very closely as well,” Beymer said.
Beymer said PeaceHealth is preparing for these challenges by modernizing its health systems and how it delivers care, and by strengthening its financial and operational resources.
She also said they are interested in learning more about and applying for Rural Transformation Funding, a program aimed at improving healthcare access and quality in rural communities, with a goal of supporting rural health innovations, improving healthcare delivery, and enhancing the rural healthcare workforce.
“That’s a resource that we will be looking at tapping into, especially for our rural hospitals, like Cottage Grove and Florence,” Beymer said.
South Lane Mental Health (SLMH) in Cottage Grove is also anticipating changes in funding and revenue sources due to H.R. 1. The mental health service provider offers scholarships and sliding-scale payment options to folks who are uninsured or underinsured, according to development manager Maureen Bell.
“We have no plans to stop offering financial hardship support, but we are limited by funding,” Bell said. “Lane County is our biggest support for scholarships, and its funds are impacted by changes at the federal level. As a priority Oregon Health Plan (Medicaid) provider, Medicaid is our largest source of revenue.”
Bell shared the uncertainty many agencies are facing due to H.R. 1.
“We are very concerned about H.R.1 because of the number of community members who will lose access to their health insurance and the reduced reimbursement rates for the services we provide. The exact effects of H.R.1 on a community mental health agency like ours are not yet known, so it is challenging to plan and prepare accordingly,” Bell said.
She noted that the loss of federal and state funding at both the local and national levels makes grants more competitive, forcing the agency to rely more heavily on individual and private donors.
Meanwhile, the need for mental health services continues to increase.
Last summer, SLMH expanded its walk-in and call-in crisis services to include Fridays and provided more than 20 additional hours of crisis services compared to the previous year. Bell also said the agency has seen a 6% increase in the number of clients served between 2024 and 2025.
In 2023, Lane County Public Health reported the communities of Junction City, Florence, and Cottage Grove all had roughly double the suicide rate of Lane County as a whole.
“It is difficult to quantify and predict the exact consequences of H.R. 1, but we do know access to affordable mental health care can save lives, keep families together, reduce law enforcement involvement, and decrease the number of people seeking mental health treatment in emergency departments,” Bell said.
United States Senator Ron Wyden late last month talked about the impacts with local healthcare professionals and leaders, saying that, “it’s a story of all health advocacy in the state; that when we go to the ramparts, and we mobilize, and we get the word out, we can beat these guys.”
