Hospital Leaders Say HR 1 Medicaid Cuts Tighten AI Spending
At Becker's 14th Annual CEO + CFO Roundtable in Chicago, health system executives described how looming Medicaid work requirements under HR 1, effective Jan. 1, 2027 in most states, are reshaping AI purchasing decisions, citing tighter return requirements, scrutiny of hidden costs, and pressure on vendors to share risk. The Commonwealth Fund has estimated the requirements could cut operating margins by up to 13.3% on average for hospitals in Medicaid expansion states. Cook County Health's Alexandra Normington said the safety-net system expects charity care costs to rise $100 million between this year and next while its funding is set to rise only about $40 million in 2027, pending a board vote, limiting its ability to adopt new technology. Other executives, from HonorHealth, Mount Sinai, Emory Healthcare, and formerly Boston Medical Center, described requiring clearer ROI projections, full cost-of-ownership calculations, and operational owners before approving AI tools.