The American Hospital Association (AHA) has kicked off a television and digital ad campaign urging lawmakers against provisions being debated for the “big, beautiful bill” the lobbying group says would threaten hospitals’ financial solvency.
The 30-second ad, which will run on broadcast and cable in the Capitol as well as online, is the latest in a concerted push from the hospital industry that has included funding projection analyses, op-eds, videos, press events and health system executives’ in-person visits with lawmakers.
It shows clips of patients receiving hospital care, leaving healthcare facilities following treatment and embracing healthcare workers. These scenes are intercut with phrases—“People count on us, now we’re counting on you” and “Tell Congress: Protect hospital care”—as well as a call for viewers to visit the AHA’s website for more information.
Placing the piece represented “a seven-figure ad buy,” for the AHA, a representative told Fierce Healthcare. The full purchase has not yet been finalized, so the duration of the campaign is “still being determined,” they said.
The AHA spent about $7 million in lobbying during the first quarter of 2025, a new high for the organization, according to lobbying expenditures tracker Open Secrets.
The AHA is also a founding member of the Coalition to Strengthen America’s Healthcare, which includes dozens of individual health systems, state hospital associations and other national-level organizations like the Federation of American Hospitals and America’s Essential Hospitals (AEH). That group has been running ads nationally for several months; its most recent, released last week, warns of service reductions, hospital closures, crowded EDs and longer wait times should reductions to the Medicaid program be signed into law.
Republicans and the White House have asserted that the final package will not cut Medicare or Medicaid but will address billions of dollars of waste, fraud and abuse within the programs.
However, the hospital groups, as well as other corners of the healthcare industry and congressional Democrats, have pointed to the impact specific provisions such as Medicaid work requirements or provider tax limitations could have on individuals and organizations.
A version of the "big, beautiful bill” passed by the House could leave more than 10 million people without health insurance by 2034, according to Congressional Budget Office projections. That reduction and a freeze on state directed payments would bring a $42.4 billion increase in hospitals’ uncompensated care costs due to a combination of fewer insured patients and Medicaid payment shortfalls, the AEH said earlier this month.
The draft version of the funding bill currently working its way through the Senate drew even sharper pushback from hospitals due to the steeper revenue cuts they’d face from additional reductions on provider taxes states use to fund their Medicaid programs.
AEH President and CEO Bruce Siegel, M.D., wrote to Senate leaders on Monday that proposed Medicaid policy changes to state directed payments in the Senate’s version of the bill “do not consider inflationary trends” and would “have a devastating impact on essential hospitals and their ability to care for patients.”
A reduction in the maximum allowable provider tax rate from 6% to 3.5% in Medicaid expansion states, meanwhile, “means states must find a way to compensate for that decreased financial support,” Siegel wrote. “Even if they do pursue a tax increase on patients, it is more likely that they will be unable to replace fully the funding provider taxes generate, as ever-growing healthcare costs tend to absorb the minimal growth in state budgets and outpace inflation. … We urge you to oppose the bill text as currently written, as it will result in losses of coverage, services and access to lifesaving care.”
Republicans have said they hope to have the bill signed by President Donald Trump by the Fourth of July. The party has narrow majorities in both chambers but faces a tough battle ahead trying to unify lawmakers in rural areas and other regions whose constituents would be hit hard by Medicaid changes and fiscal hawks looking for additional spending cuts.
Recent polling from KFF and others—which the hospital industry has not hesitated to leverage—have also outlined disapproval for the bill among a majority of adults. Public disapproval of changes that would affect Medicaid coverage increases when surveyed adults were informed of the impacts of specific provisions. The poll also found bipartisan, all-time high overall favorability for Medicaid and the Affordable Care Act.