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SILEX, Missouri — A bold new billboard near the shuttering Silex
Wellness Center reads: “UNDER TRUMP’S WATCH, THE SILEX CENTER IS CLOSING ITS DOORS.”

The sign is part of a national campaign by the Democratic National
Committee (DNC) targeting rural communities where hospitals are closing
or cutting services following passage of the GOP’s 2025 reconciliation package known as the One Big Beautiful Bill (OBBB).

A day before President Trump signed the bill into law on July 4, the
Silex Center in Lincoln County announced it would close.

In Missouri, the warning hits home. According to new research from
Washington University in St. Louis, the state will lose approximately
$10.9 billion in Medicaid hospital funding under the bill. A newly
created rural hospital fund is projected to cover only 71.6% of those
cuts, leaving more than $3 billion in unfunded need.

“Rural hospitals were already on the brink of collapse thanks to Donald Trump, but now he has put the last nail in the coffin,” DNC Chair Ken
Martin said. “It’s Trump’s own voters who will suffer the most.”

The DNC’s billboard directs viewers to a website labeled "Trump Tax" and argues that the legislation constitutes a betrayal of the very
communities that helped elect the former president.

"If you’re not a billionaire, you’re getting screwed over," the website says.

But now, Sen. Josh Hawley, who cast the deciding vote in favor of the
OBBB, says he’s working to undo parts of it.

On July 15, Hawley introduced the Protect Medicaid and Rural Hospitals
Act, which would repeal upcoming changes to Medicaid provider taxes,
rescind reductions in directed payments to hospitals, double the rural
hospital fund to $100 billion, and extend its lifespan from five to ten
years.

“President Trump has always said we have to protect Medicaid for working people. Now is the time to prevent any future cuts to Medicaid from
going into effect,” Hawley said in a news release. “Under the recent reconciliation bill, Missouri will see an extra $1 billion for hospitals
over the next four years.”

However, health care analysts dispute that figure.

“When Josh Hawley is saying that he has brought home a billion dollars
to Missouri for rural hospitals, that is just, you know, plainly not
true,” said Emily Gee, a health economist and former Obama-era official
at the U.S. Department of Health and Human Services. “There’s no
guarantee that that will be the slice of the pie that Missouri gets.”

The rural hospital fund created by the OBBB requires states to apply for competitive grants. Half of the funds are distributed evenly among
states regardless of need, and the other half is controlled at the
discretion of CMS Administrator Mehmet Oz with no requirement for public disclosure or review.

In an earlier interview with CNN, Hawley acknowledged flaws in the
legislation he voted for: “There are aspects of it I didn't like, and I
think these future cuts to hospitals with Medicaid is a mistake. So I
said when I voted for it, I said I'm going to try to reverse these.
That's exactly what I'm doing."

But critics say that’s too little, too late.

At a recent press event where Hawley was celebrating the bill's passage,
Five On Your Side’s political editor Mark Maxwell pressed Hawley: "You
built something of a national soapbox saying that cuts to Medicaid would
be morally wrong, politically suicidal... How do you think voters in
Missouri feel hearing you say all that and then vote for it anyway?"

“Well, I hope that they… recognize they're gonna get a billion dollars more,” Hawley replied.

Policy experts counter that the CBO projects a trillion-dollar national
cut to Medicaid under OBBB and that the work requirements alone are
likely to knock thousands of Missourians off their health insurance. A
2019 study in the New England Journal of Medicine found that similar
policies in Arkansas led to “a significant loss of Medicaid coverage… (with) no significant changes in employment.”

In Missouri, more than 1.2 million residents rely on Medicaid, including
36% of children, 40% of births, and 65% of nursing home residents.

As the Silex Center prepares to close, four rural hospitals in Missouri
are listed as at-risk for shutdown or service reductions: Bothwell
Regional Health Center (Sedalia), Scotland County Memorial Hospital
(Memphis), Parkland Health Center (Bonne Terre), and Lafayette Regional
Health Center (Lexington).

Whether Hawley’s bill will gain traction with his Republican colleagues remains uncertain. But for many rural residents, the consequences are
already unfolding.

https://www.ksdk.com/article/news/local/new-billboard-silex-blames-trump- hawley-scrambles-to-reverse-medicaid-cuts/63-d866ea0c-cfc4-4bcd-8255-8773 0b18568d

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