Sherry Norquist, MSN-RN, Executive Director, Community Engagement & Impact, Sentara Health
Surviving the Big Beautiful Bill Is Possible, But It Won’t be Easy
Recent events have caused growing concern across the nation including changes to programs under newly passed federal legislation — the One Big Beautiful Bill Act.
The concern is valid. People and non-profits will face difficult decisions that could directly affect access to care for low-income families, children, seniors and individuals with disabilities. It’s a reality that all of us — lawmakers, health care providers, nonprofits, funders and communities — must face head-on, and one that will require working together in new ways to ensure we protect the most vulnerable.
For decades, Sentara has been committed to improving access to care for those most in need, especially in medically underserved and economically disadvantaged communities. In 2024 alone, Sentara invested $329 million into our communities. Of that, $174 million went to uncompensated care — much of which supported Medicaid patients and those without insurance — and $40 million was distributed directly to nonprofits and community programs addressing social determinants of health like housing, food security and behavioral health. These numbers represent real families receiving cancer screenings, seniors accessing prescription medications and children receiving care in mobile health clinics brought into their neighborhoods.
Safety-net hospitals and rural providers will be hit particularly hard. Some are already operating on razor-thin margins and simply can’t absorb further cuts without scaling back essential services or, in some cases, closing their doors. The loss of any provider, urban or rural, ripples through entire communities, disrupting emergency response, prenatal care, chronic disease management and behavioral health services (further aggravating ER boarding, long wait times, left without being seen and possible adverse outcomes).
While the challenges ahead are serious, we are not without options. What this moment calls for is a coordinated response that blends responsible policymaking with the collaborative spirit that funders and nonprofits are known for. We must look for ways to serve the communities who rely on us, advocate for those without a voice, and work alongside state leaders, nonprofit partners and fellow health systems to navigate the road ahead.
The challenge before us will require unity, innovation and leadership. Strategic partnerships demonstrate that by working together, we can build systems that serve everyone — fairly and effectively.