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The One Big Beautiful Bill is not a theoretical threat anymore. It has passed. It is the law. And now Milwaukee is running out of time before its full implementation changes the way health care is delivered in every corner of this city.
For many families across Milwaukee — especially Black and Brown residents on the North and South Sides — the bill’s rollout will feel less like policy and more like a punch to the gut.
The question is no longer “What happens if it passes?” It is now:
What happens when the cuts start hitting the places we depend on?
On paper, the bill restructures Medicaid and reduces the 340B drug discount program. In real life, it means the beginning of a financial shock Milwaukee’s safety net is not prepared to absorb.
What’s at stake
Every Milwaukee Community Health Center is expected to lose $450,000–$550,000 per clinical site in Year One. Not over five years. Not gradually. In the “first” year of implementation.
These losses trigger a painful cascade:
– Fewer primary care appointments
– Reduced behavioral health services
– Fewer OB/GYN and prenatal visits
– Shrinking addiction treatment and recovery services
– Less bilingual and culturally aligned staffing
– Longer wait times
– Increased dependence on overcrowded hospital ERs
Milwaukee’s hospitals will be overwhelmed because health centers will be forced to do less. And when health centers pull back, families with the least resources — particularly Black and Brown households — are the first to feel the impact.
Milwaukee already leads the nation in disparities in diabetes, hypertension, asthma, maternal health, infant mortality, and behavioral health concerns. Now, the very institutions buffering those disparities are at risk of losing the most.
The bill has been wrapped in complicated language, budget summaries, and government timelines — but there has been almost no practical explanation of what it means for everyday people. Most families will only learn its impact when a clinic says:
“We’re sorry — this program no longer has funding.”
When inequity becomes institutionalized
That is how inequity becomes institutionalized: not through sudden events, but through slow financial collapse.
With implementation moving forward, Milwaukee must look toward the solutions it can still control.
The only realistic way for Milwaukee’s Community Health Centers to replace OBBB losses — without cutting services or shifting costs to families — is to bring clinical research directly into the community.
Clinical research is no longer confined to major universities or wealthy suburbs. It can happen inside Milwaukee’s health centers, in the neighborhoods most affected by disease — and it can bring millions of private-sector dollars directly into patient care.
These are unrestricted funds, not grants or short-term emergency relief. They can pay for:
– Primary care providers
– Behavioral health clinicians
– Bilingual staff and care navigators
– Community outreach workers
– Expanded access for uninsured and Medicaid patients
– Stabilization of essential programs threatened by OBBB cuts
Clinical research also gives Milwaukee residents **early access to innovative treatments** years before they reach the market. Historically, Black and Brown communities have been excluded from trials — and therefore excluded from medical innovation. Community-based research reverses this pattern.
It strengthens clinics. It protects services. It keeps doors open. And it does so without raising costs for families.
With implementation underway, Milwaukee residents have the right to ask their health centers:
1. What is your plan to replace the revenue lost under the OBBB?
2. How will you safeguard vulnerable patients during implementation?
3. Why aren’t we participating in clinical research as a revenue strategy?
4. How quickly can we begin?
These are not academic questions. They are survival questions.
Milwaukee’s history is one of resilience — from its civil rights leadership to its community organizing, to its fierce advocacy for equity and justice. This moment demands the same resolve before the full force of implementation reshapes access to care across the city.
Before the OBBB lands with full weight, Milwaukee must take the steps it still can:
– Bring clinical research into health centers
– Protect services families depend on
– Use private investment to buffer public cuts
– Ensure Black and Brown neighborhoods are not left behind — again
The bill has passed. Implementation is coming. The timeline is real. But with decisive action, Milwaukee can protect its safety net, strengthen its clinics, and preserve the care its people trust.
Milwaukee’s future depends on what we do right now.
Dr. Vincent J. Thompson and Dr. Johan Cruz-Polanco are co-founders of the Community Health Clinical Research Corporation, which brings clinical research opportunities — and the revenue they generate — directly into America’s Community Health Centers to protect access to care for underserved communities.
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