More than 300 rural hospitals face immediate closure threat as Senate Medicaid cuts loom
More than 300 rural hospitals are at immediate risk of closing, and proposed Senate Medicaid cuts could push even more to the brink. Lawmakers debate how to protect these vital health centers as the clock ticks down to the July 4 deadline.
More than 300 rural hospitals are at immediate risk of closing, and proposed Senate Medicaid cuts could push even more to the brink. Lawmakers debate how to protect these vital health centers as the clock ticks down to the July 4 deadline.
More than 300 rural hospitals are at immediate risk of closing, and proposed Senate Medicaid cuts could push even more to the brink. Lawmakers debate how to protect these vital health centers as the clock ticks down to the July 4 deadline.
As Senate Republicans race to finalize President Donald Trump’s sweeping tax and spending bill, one major piece of the package has emerged as a flashpoint: deep cuts to Medicaid that some lawmakers and advocates warn could push rural hospitals to the brink of collapse.
The most recent blow came when the Senate Parliamentarian struck a key Medicaid provision from the bill, ruling that proposed limits on so-called provider taxes — fees states collect from hospitals to boost federal reimbursements — violated chamber rules. The provision would have capped how much states can collect, a change critics say would gut health care systems in small towns and remote areas.
“It’s a good opportunity for the Senate to get this right and not defund rural hospitals,” said Sen. Josh Hawley (R-Mo.). “I am completely opposed to defunding rural hospitals.”
Negotiations over how to replace or revise the provision have quickly become one of the biggest challenges to getting the bill passed by Trump’s self-imposed July 4 deadline. While the bill includes a mix of tax cuts and spending reductions, Medicaid remains the primary target for cost savings, something that alarms rural advocates who say the program is a lifeline in places where few alternatives exist.
“What’s at stake is, well, just everything,” said Greg York, who works at an independent living center in Coffeyville, Kansas. “All we do is dependent upon those dollars. If we can’t provide those self-directed, home and community-based services, then yeah, a lot of things go away.”
One in three rural hospitals is now at risk of closing, according to the Center for Healthcare Quality and Payment Reform. More than 300 are in immediate danger.
“Even in the best financial situations, rural hospitals are deeply dependent on Medicaid funding for survival,” said Michael Shepherd, a health policy researcher at the University of Michigan.
The bill’s architects insist the plan will rein in the federal deficit and keep taxes from rising next year.
“We’re making some common-sense reforms to Medicaid to eliminate waste, fraud, and abuse,” said Senate Majority Leader John Thune.
But that argument doesn’t sit well with those who see the program as already stretched thin.
“It’s difficult for me to believe, in my mind, that there’s that much fraud, waste, and abuse,” York said.
To soften the blow to rural providers, GOP lawmakers are floating a proposal to create a rural hospital stabilization fund. One version would allocate $15 billion over five years, though some lawmakers have pushed for as much as $100 billion. Details remain thin, and there’s growing concern about how the money would actually reach the hospitals that need it most.
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