A significant portion of military personnel, veterans, and their families may be relying on hospitals facing increasing financial strain, largely due to recent changes to Medicaid funding. A new analysis led by Harvard T.H. Chan School of Public Health reveals that over 3.5 million TRICARE beneficiaries could be impacted by potential cuts to services at hospitals already operating with limited resources. This situation highlights a critical intersection between federal healthcare policy and the well-being of those who serve, raising concerns about access to quality care for a vulnerable population.
The analysis, conducted by researchers at the Healthcare Quality and Outcomes Lab (HQO), including Josh Calianos, Jessica Phelan, Jose Figueroa, and Thomas Tsai, underscores a growing reliance on civilian hospitals for military healthcare needs. Service members and their families often utilize civilian facilities for urgent or specialized care, or when military treatment facilities are inaccessible. Though, many of these hospitals depend heavily on Medicaid reimbursements, and proposed changes to the program—stemming from the “One Huge Beautiful Bill” (OBBBA)—could jeopardize their financial stability.
The OBBBA, signed into law in July 2025, introduces new requirements for Medicaid recipients, including documentation of employment or exemption from work requirements, starting in January 2027. Experts predict these changes could lead to a reduction of approximately 10 million people from Medicaid by 2030, with 7.6 million projected to turn into uninsured, according to estimates from the Congressional Budget Office. This potential loss of coverage extends beyond Medicaid enrollees, impacting the financial health of hospitals that serve a broad patient base, including those insured through TRICARE.
“Military active duty service members on TRICARE and their families also on TRICARE are increasingly relying on civilian hospitals for their care, even when they’re living within a military base,” explained Jose Figueroa, a researcher involved in the study. “If we’re finding evidence that there are many hospitals across the country that are at risk, to what extent will that affect military personnel and their families?”
Assessing the Risk to Military Families
The HQO analysis identified 8.9 million TRICARE beneficiaries and examined their proximity to hospitals at risk of financial distress. Researchers assessed hospitals based on their reliance on Medicaid and their status as “safety net” hospitals—those serving a disproportionate number of uninsured or Medicaid-insured patients. Their findings revealed that more than 3.5 million TRICARE beneficiaries live near hospitals categorized as having high or moderate financial risk. Specifically, over 724,000 military personnel and their families residing on military installations may be exposed to hospitals with multiple risk factors for financial instability. In total, more than 4 in 10 TRICARE beneficiaries—over 3.5 million people—may be affected.
Thomas Tsai, another researcher involved in the analysis, emphasized the importance of these findings. “we found that a substantial proportion of TRICARE beneficiaries depend on hospitals that face an elevated risk of financial distress,” he stated. “This highlights an important opportunity for policymakers to ensure continued access to high-quality hospital care for our military families.”
Legislative Scrutiny and Potential Impacts
The HQO analysis has already garnered attention from federal lawmakers, who are examining the potential consequences of the OBBBA on military families. The researchers noted that the changes to Medicaid, driven by H.R. 1, could have far-reaching implications for healthcare access across the country. Figueroa underscored the importance of prioritizing the health and well-being of those who serve, stating, “As a country, we should do our best to take care of the people protecting us. Military personnel and their family members should be protected, and sometimes we have to remind ourselves that drastic cuts to our health care that affect our health delivery system also affects our active military personnel and their families as well.”
The potential financial strain on hospitals could lead to reduced services, longer wait times, and limited access to specialized care, impacting all patients, not just those covered by Medicaid or TRICARE. This situation underscores the interconnectedness of the healthcare system and the potential for policy changes to have unintended consequences.
Read the HQO analysis: Military Community Potentially Exposed to Hospitals at Higher Risk of Financial Distress
Read the ABC News article: Many military members may get care at hospitals at risk of financial distress – partly due to Trump cuts
The long-term effects of these Medicaid changes remain to be seen, but ongoing monitoring of hospital financial health and access to care will be crucial. Policymakers will need to carefully consider the potential impact on military families and ensure that those who have served our country continue to receive the high-quality healthcare they deserve.
Disclaimer: This article provides informational content and should not be considered medical or financial advice. Consult with a qualified healthcare professional or financial advisor for personalized guidance.
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