Since it was signed into law on July 4, West Texas Republican Congressman Jodey Arrington has been broadly praised by allies for his stewardship of the so-called One Big Beautiful Bill Act (OBBBA). U.S. House Speaker Mike Johnson called Arrington, who chairs the powerful House Budget Committee, “one of the most effective and consequential members of Congress.” And Arrington has wasted no time touting his victory in West Texas, proclaiming it to be a “game changer for Rural America” and “a big beautiful win for West Texas.” He’s argued the so-called entitlement cuts to Medicaid, the Affordable Care Act (ACA), and the Supplemental Nutrition Assistance Program will “root out waste and fraud.”
But many of his constituents in Congressional District 19—a vast, deeply red rural district that includes over 30 counties—stand to lose access to both their healthcare and their local hospitals under the massive tax-and-spending bill, which will slash Medicaid and ACA spending by more than $1 trillion and knock 10 million more people off of insurance nationwide over the next 10 years, according to Congressional Budget Office estimates. Arrington’s district is home to more rural hospitals than any other in Texas, and roughly a quarter of those are at risk of closing under the new law, according to a recent study. Six of the 25 hospitals in the 19th are at risk of closing, according to a June study by the Cecil G. Sheps Center for Health Services Research at the University of North Carolina. Using data from 2020 to 2022, the study defined at-risk rural hospitals as those with three consecutive years operating with a negative profit margin or those which receive a disproportionately large share of revenue from Medicaid.
