St. Charles Madras listed as ‘at risk’ amid Medicaid cut concerns

Published 4:25 pm Thursday, July 10, 2025

St. Charles Madras. (Bulletin file)

St. Charles Madras was among four Oregon hospitals on a list of 300 rural hospitals deemed at risk of closing or cutting services as a result of $500 billion in cuts to Medicaid over the next decade.

But hospital officials say the Madras hospital, operated by St. Charles Health System, is not at risk of closing.

The list, part of a study by the Cecil G. Sheps Center for Health Services Research at the University of North Carolina, was cited in a letter from Oregon Democratic Sens. Ron Wyden and Jeff Merkley among others in Congress asking President Donald Trump and Congressional Republicans to reconsider the unprecedented cuts to healthcare in Trump’s “One Big Beautiful Bill” that recently passed in Congress.

The cuts would have dire consequences for rural hospitals nationwide and in Hermiston, Seaside, Madras and Silverton, the lawmakers said.

In Oregon, one in three residents receive health insurance through the Oregon Health Plan, which is the state’s Medicaid program.

In 2024, St. Charles Madras received 37.7% of its revenues from Medicaid reimbursements, according to data provided by the Oregon Health Authority.  About 41% of the patient revenues came from Medicare, and the balance from private insurance, uninsured or other forms of reimbursement, according to the data from OHA.

But the 25-bed hospital, which employs 206 people, is not at risk of closing, said Todd Shields, St. Charles Madras and Prineville vice president and hospital administrator.

“St. Charles Madras is not at risk of closing and benefits from being part of a strong health system,” Shields said in an email to The Bulletin. “The organization as a whole finished 2024 with a modestly positive operating margin — better than many of our similar-sized counterparts.”

Also in 2024, the year data are most current, St. Charles Madras discharged 741 patients, about the same as in 2022. It saw 15,209 patients in the emergency department and performed 552 outpatient surgeries in 2022, according to the St. Charles Health System’s annual report.

“We are optimistic about our future, even while we face headwinds at the state and federal level,” Shields said. “We are learning about all the ways this new federal legislation will impact health care in Oregon. It will take time to fully understand the implication, but for now, we want our patients and community to know that we remain committed to keeping care local.”

Merkley and Wyden stated that the changes in Medicaid could put up barriers to healthcare for Oregonians, and worsen access to care for everyone. More than 600 health professionals in Oregon signed a petition expressing fear that the  changes to enrollment that cut Medicaid and Affordable Care Act coverage could dismantle the Oregon Health Plan and push people off coverage and destabilize hospitals and clinics.     

The tax cut and spending bill Congress approved last week includes cuts to federal health spending by about $1 trillion. The cuts to Medicaid and the Affordable Care Act will cause nearly 12 million people to be without health insurance by 2034, according to some estimates. 

Oregon’s five Democratic U.S. House members and two senators voted against the measure, which was signed by Trump on July 4. But Republican Rep. Cliff Bentz supported the measure in the House. 

“This fresh, independent data concluding Republicans’ cuts to Medicaid would threaten the functions and very existence of 300-plus hospitals should have sounded an alarm for Donald Trump,” said U.S. Sen. Ron Wyden, D-Ore. “This study analyzing financial indicators to make its dire forecasts from those cuts is serious and I’ll never stop working to keep the doors open at these rural Oregon hospitals in Madras, Hermiston, Seaside and Silverton.”

About Suzanne Roig

Suzanne Roig has been a reporter with The Bulletin since 2018 covering business and health in the region. When she's not working she enjoys taking her dog, Pono, out on hikes. She can be reached at 541-633-2117, suzanne.roig@bendbulletin.com.

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