Like every single high-ranking hospital administrator in America, Cottage Health CFO Matt Morgan has good reason to stay awake nights worrying about the flood of newly uninsured patients — courtesy of Donald Trump’s HR 1, or Big Beautiful Budget Bill— seeking treatment for which they cannot pay. Being a chief financial officer, Morgan selects his words with care and is not given to histrionic rhetoric. “We’re not nervous,” he says, “so much as looking forward expectantly.”
There’s a whole lot coming down the pike for Morgan to be expectant about. Come January 1, 2027, Trump’s new and tougher eligibility requirements for Medicaid recipients will kick into gear. When that happens, Morgan said he expects the number of uninsured patients at Cottage — “self-paying” is the term of art — to increase by 300 to 500 percent. Right now, Morgan said, Cottage has about 4,000 to 5,000 self-paying patients.
By law, hospitals are barred from refusing service to people in need because they can’t pay. As a last resort, people without insurance or means typically avail themselves of the nearest emergency room when medical challenges achieve critical mass…