Just two weeks after voting for a GOP megabill that slashed Medicaid, Senator Josh Hawley (R-Mo.) is trying to roll back the damage. On July 15, he unveiled the Protect Medicaid and Rural Hospitals Act, which he claims will block future Medicaid cuts and double funding for rural hospitals.
He’s calling it a fix—critics are calling it a flip
Hawley’s new bill would:
- Repeal upcoming limits on provider taxes, which states use to access federal Medicaid funds.
- Cancel caps on state-directed payments that would reduce hospital reimbursements.
- Double the Rural Health Transformation Fund from $50 billion to $100 billion.
- Extend the fund’s lifespan from five years to ten.
“Now is the time to prevent any future cuts to Medicaid from going into effect,” Hawley said. “We should increase support for rural hospitals nationwide.”
The senator says Missouri will receive $1 billion more for hospitals over four years under the reconciliation bill—money he helped secure.
But here’s the twist: he voted for those Medicaid cuts
Hawley’s critics say his new stance reeks of political backpedaling. He voted for the “One Big Beautiful Bill” on July 1, which included $1 trillion in Medicaid cuts over the next decade. Days later, he turned around and introduced a bill to stop them.
NBC News and MSNBC’s Maddow Blog highlighted the timeline:
- June 28: Hawley slams GOP Medicaid cuts as “morally wrong.”
- July 1: He votes for the bill anyway.
- July 9: He denounces the cuts again.
- July 15: He tries to repeal them.
This rapid reversal has triggered media scrutiny and accusations of hypocrisy.
What’s at stake for rural hospitals?
Health policy analysts say the original bill puts rural hospitals in a financial vise. A KFF analysis estimates rural Medicaid funding could drop by $155 billion over 10 years. Even if Hawley’s bill passes, experts argue it may not fully offset the damage.
Hospitals in Missouri and other rural states say they face tough decisions—cut services, lay off staff, or shut down entirely.
Is this political damage control?
Many see Hawley’s move as an effort to limit fallout ahead of his next campaign. Despite his original support for the cuts, he now positions himself as a Medicaid defender and rural health advocate.
In May, Hawley wrote in The New York Times:
“We must ignore calls to cut Medicaid. Slashing health insurance for the working poor would be both morally wrong and politically suicidal.”
He now seems to be trying to prove he meant it.
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