Medicaid Cuts Would Threaten Rural Hospitals

https://www.americanprogress.org/article/medicaid-cuts-would-threaten-rural-hospitals/

A registered nurse walks the floor during her shift, October 2024. (Getty/AAron Ontiveroz)A registered nurse walks the floor during her shift, October 2024. (Getty/AAron Ontiveroz)
More than 66 million Americans live in rural areas, according to the 2020 census. In these communities, Medicaid is a source of coverage for more than 18 percent of adults under 65 and provides financial support to keep rural hospitals operating.

Small rural hospitals are often responsible for delivering most of the health care services for people living in the communities they serve, including long-term care and primary care. These hospitals can be rural communities’ only source of emergency, preventive, and specialized care—including obstetrics and behavioral health services.

Nearly one-third of rural hospitals across the United States are at risk of closure due to financial instability. According to the Center for Healthcare Quality and Payment Reform, more than 300 rural hospitals are at “immediate risk” of closure because they have suffered multiyear financial losses or have very low financial reserves. In other words, these facilities are in such a precarious financial condition that closure could come at any time. Some facilities have already closed entire units or cut back on certain types of care as part of cost saving measures. For example, between 2011 and 2023, 293 rural hospitals stopped providing obstetrics services, representing 24 percent of the country’s rural obstetric units.

Against this backdrop, congressional Republicans are considering proposals that would amount to the largest Medicaid cut in the program’s history. For rural hospitals that rely on Medicaid to finance care, such cuts could accelerate a crisis already on the brink.

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