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How Healthcare Cuts in Big Beautiful Bill will Impact RVA

August 7, 2025
By: Colleen Phelps

The worst of Donald Trump’s Medicaid cuts have not even arrived yet, and local doctors and hospitals are in a panic.  “It is extremely alarming”, says Dr. Bruce Silverman of Richmond. Silverman is a retired Nephrologist, who now serves as Medical Director of Goochland Cares (free clinic), as well as a physician and patient advocate. “Nothing is more important than your family and their health and wellbeing. And this bill attacks every aspect of that, no matter how rich or how poor you are”, Silverman says.

While a lot of concern is focused on Southwest Virginia and rural areas that may face hospital closures, the fact is that Trump’s Big Beautiful Bill, that was signed into law on July 4th, will kick more than 300.000 Virginians off of their healthcare, and affect all of us.

He expects that Richmonders will see longer waits at the emergency room, “everyone who is thrown off Medicaid will no longer have a primary care physician to go to for anything – the biggest things and the littlest things. So where are they going to get their care now, they’re going to the emergency room”, Silverman says. Emergency rooms are not designed for primary care, which could delay help in cases of real emergencies, “that can be disconcerting when your husband is having a stroke or a heart attack, and there is a defined window to get to the emergency room. You have to be there within a very narrow window, that’s where it’s going to affect you and I”.

He also says prepare for co-pays to go up when you see a specialist. Many specialists will no longer be taking Medicaid patients, Silverman says, which means they will have to increase charges to insurance companies. “Your co-pays may be higher and your deductibles may be higher, to make your health care insurance affordable, you’ll be paying more out of pocket”.

There are 70 free clinics across Virginia, serving about 110,000 people. While doctors are typically volunteers, the nurses and administrative staff are not. Since free clinics will be losing some federal funding, Silverman worries that some may have to close. Silverman says free clinics are already overrun with patients even before the full Medicaid cuts take effect.

He has long term concern about what these cuts will mean overall to medicine in the United States. Silverman says countries like Canada, and many in Europe have already put out notices to U.S. doctors, scientists and researchers that they welcome them.

Canada, for example, has had an increase of over 700% of American doctors applying for medical licenses in Canada, says Silverman. And he says he understands doctors and researchers looking to practice in other countries, “They are trusted by the public, they are valued for their knowledge, their clinical experience and they can do research in an environment where they don’t have to worry about something being labeled as DEI and cancelled. For example a study on how to help maternal/fetal outcomes in women of color would be considered DEI and likely cancelled”.

“The NIH, for decades now, has been the largest funder of research in the world”, Silverman says. That will all change under the Trump administration.

Take Action

  • Share this article with a friend who cares about Medicaid and healthcare.
  • Call Congressman Rob Wittman (R-CD1) and tell him you are disappointed that he voted for changes that will cause people to lose their healthcare and negatively impact rural hospitals.
  • Join an organization that is interested in medicare for all,  (http://PNHP.org – you don’t have to be a physician to join)

Learn More

  • Read Mel Tull’s letter responding to Rob Wittman’s support of cuts to Medicaid

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Denise Good Troubl

“What brings me out is the future of my grandchildren and my great grandchildren and bad things for the working class. People fought so hard to get us where we are, I was hoping we’d never go back, we’d just keep moving forward and make it better. But we’re going backward, and it’s getting worse.”

Amy Good Trouble

“I object to what’s going on. Every morning I wake up and open the newspaper like ‘What fresh hell will there be today?’ And there are so many issues that I’m absolutely horrified by that it’s hard to list them all. My partner is on Medicaid and they craftily cut it – for after the midterms. He has a large number of health issues, and it’s going to be very difficult for him to get healthcare. It’ll be really tough.”

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