“Under reconciliation you can push a Medicaid cut’s effective date to 2027, but you can’t hide its impact. CMS still publishes the lower 2027 rates on Nov 1 2026,

PAYGO rips 4 % out of Medicare on Jan 1 2026, and every hospital CFO has to budget for those hits this July—which is exactly why Curtis Medical Center closed two days into the new fiscal year. The idea that ‘nobody will know until after the election’ is fantasy.”