$911 billion. That’s the amount federal lawmakers are cutting from Medicaid over the next decade under the One Big Beautiful Bill Act, signed in July 2025. And three Long Island hospitals are now on a watch list of institutions that may not survive the financial hit.
Nassau University Medical Center in East Meadow, Stony Brook University Hospital in Suffolk County, and Mercy Medical Center all appear among 446 hospitals flagged nationally by Public Citizen, a nonprofit consumer advocacy organization. Forty-five of those hospitals are in New York State. The group’s researchers combed through years of financial data and concluded that each of these institutions is dangerously exposed.
The case of Nassau University Medical Center is the most alarming of the three. Audited financial statements from the Nassau Health Care Corporation show that Medicaid programs funded 65% of NUMC’s total spending in 2024. The hospital was already running budget deficits before Washington started talking about cuts. It doesn’t have reserves to absorb a revenue shock of this scale.
Public Citizen researcher Eileen O’Grady authored the report and was blunt about the stakes. “Trump’s cuts to Medicaid will hurt millions of low-income and disabled Americans, and will deepen financial strains that are already plaguing rural and safety-net hospitals, compromising their ability to deliver care, potentially leading many to close,” O’Grady said, as reported by the Long Island Press.
She also called on Congress to restore the full Medicaid funding cuts and extend enhanced premium tax credits available through the Affordable Care Act marketplaces.
The methodology wasn’t soft. Public Citizen pulled hospital financial data from the Centers for Medicare and Medicaid Services covering 2022 through 2024. A hospital made the vulnerable list only if it met two conditions: 20% or more of its revenue came from Medicaid or other low-income government payers, and it had been operating at a net loss. Both conditions apply to NUMC. Stony Brook University Hospital and Mercy Medical Center cleared the same thresholds, which is why all three ended up on the list.
What does landing on that list actually mean? Think layoffs. Think emergency room consolidations, specialty care cutbacks, or outright closure. These aren’t hypotheticals researchers invented. They’re the documented outcomes when safety-net hospitals lose a primary funding source without a replacement.
Medicaid isn’t a marginal program. It’s a joint federal-state partnership that covers children under 18 from low- and moderate-income families, pregnant women, parents who can’t afford private insurance, and people with disabilities. Nationally, 77 million Americans rely on it. New York runs one of the most expansive Medicaid programs in the country, and in the state’s 2025 fiscal year, federal Medicaid spending here totaled $69.2 billion, according to the state Comptroller’s office. The Centers for Medicare and Medicaid Services report that Medicaid funds roughly 20% of all hospital spending across the country. Cut that share, and the math turns brutal almost immediately for institutions that can’t shift costs to privately insured patients.
Nassau University Medical Center has always operated differently than a typical suburban hospital. It’s a public institution. It can’t turn away patients who can’t pay, and it doesn’t have a wealthy donor base or commercial payer mix to fall back on. That’s why the 65% Medicaid dependency figure isn’t just a data point. It’s the entire business model.
Congress pushed the One Big Beautiful Bill Act through in 2025, and the cuts are structured to accelerate through 2026 and beyond. State officials and hospital administrators knew reductions were coming, but the Public Citizen report puts specific names and balance sheets behind what had been an abstract policy debate. For the patients who use NUMC’s emergency room in East Meadow, or Stony Brook’s services in Suffolk County, or Mercy Medical Center’s facilities, the numbers in this report are not abstractions.
The question Long Island taxpayers should be asking right now: if these hospitals close or cut services, who pays for the patients who show up anyway, and where will they go?