Map Shows Where Medicaid Cuts Could Close Hospitals

Newsweek

14-05-2025

Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources.
As congressional Republicans consider deep cuts to the Medicaid program, hundreds of rural hospitals already facing severe financial strain may be pushed to closure.
With more than 300 rural hospitals identified as being at "immediate risk" of shutting down, reductions in Medicaid funding threaten to upend health care delivery in some of the nation's most vulnerable communities, according to the pro-Democratic organization Center for American Progress.
Why It Matters
More than 60 million Americans live in rural areas, according to the 2020 census, where hospitals serve as essential lifelines, not just for emergency and primary care, but also for obstetrics, mental health services and long-term treatment. Medicaid provides critical financial support for these institutions, often serving as the backbone of care in areas with thin profit margins and high rates of public insurance enrollment.
Nearly one-third of the nation's rural hospitals are already in danger of closing due to sustained financial losses and low cash reserves, according to the Center for Healthcare Quality and Payment Reform, meaning Medicaid cuts would likely see these facilities shut down.
What To Know
The Center for Healthcare Quality and Payment Reform has identified over 300 rural hospitals at "immediate risk" of closure, as shown in the map above.
The states that could see the highest number of closures include Kansas, Oklahoma and Alabama, all of which voted for President Donald Trump in the 2024 presidential election.
Across all the states that expanded Medicaid enrollment, 190 rural inpatient hospitals are at "immediate risk of closure" already, meaning Medicaid cuts would likely see these facilities shut down as House Republicans seem poised to target the states that expanded Medicaid enrollment under the Affordable Care Act (ACA), also known as Obamacare.
Almost one in three inpatient rural hospitals in Oklahoma and New York could close, and around one in four in Pennsylvania and Virginia.
Residents of rural areas are also more likely than those in urban communities to rely on Medicaid or the Children's Health Insurance Program (CHIP) for their health insurance, according to the pro-Democratic organization Center for American Progress.
Per the CAP, almost 40 percent of children in the small towns and rural areas of Virginia were covered by Medicaid and CHIP in 2023, while around 20 percent of adults younger than 65 were.
The ACA expanded Medicaid eligibility to cover low-income adults up to 138 percent of the federal poverty level, which has been a lifeline for many rural institutions.
However, the new budget resolution passed by Republicans has instructed the House Committee on Energy and Commerce to slash $880 billion in spending over the next decade, with Medicaid making up 93 percent of the committee's budget.
Proposed changes include lowering the federal match rate for expansion enrollees and imposing work requirements.
Democratic Representative Alexandria Ocasio-Cortez has spoken out about her concern that a number of rural hospitals in New York could close, where significant proportions of constituents rely on Medicaid coverage.
What People Are Saying
Craig Wilson, interim president and CEO for the Arkansas Center for Health Improvement (ACHI), a nonpartisan, independent health policy center based in Little Rock, Arkansas, told Newsweek: "There are already existing inflationary pressures on hospitals generally, but in a state where the healthcare providers in many of our rural counties and the residents they serve are heavily dependent on this safety net program, it would be difficult to absorb."
He added: "Regardless of what the policy decisions are in Congress, there is a clear signal from the federal government that their goal is to shift more of the financial responsibility for the Medicaid program to the states. If states want to maintain the integrity of their Medicaid program and broader healthcare system and rural communities want to maintain access to services locally, they should recognize this shift and organize to respond."
A notification on the website of New York Democratic Representative Alexandria Ocasio-Cortez says: "Next week, the House Energy & Commerce Committee will vote on a bill that cuts Medicaid. Republicans are setting out to cut $880 billion in healthcare from families across the United States."
It adds: "If you are represented by a Republican, please call them now and leave a voicemail, or call first thing on Monday to get through to their office. Public pressure can work here. Many members are in close seats, and hearing from their constituents can make a difference."
Representative Brett Guthrie of Kentucky, the GOP chairman of the Energy and Commerce Committee, said: "Savings like these allow us to use this bill to renew the Trump tax cuts and keep Republicans' promise to hardworking middle-class families."
House Speaker Mike Johnson said: "Medicaid is intended, remember, as a safety net for young pregnant mothers and the elderly and disabled and vulnerable populations, not for young able-bodied men without dependents. Those are the kinds of people we're taking off the program."
Eileen M. Sullivan-Marx, a professor at the New York University Rory Meyers College of Nursing, told Newsweek: "I had a rural primary care practice in eastern New Hampshire as a nurse practitioner in the 1980s. I saw first hand how local communities benefited from having rural hospitals. Not only were the rural hospitals part of the local economy and supportive to local nursing homes but they also provided a sound structure to local community governance and volunteer community services that we often see with business groups in communities. For example, charity fund raising and support of school activities go hand in hand with rural hospitals. Those employees and leaders at local rural hospitals are the same persons who hold communities together to support not only health but also community economic growth. Just think of Friday Night Football games, usually a medical professional (in New Hampshire it had to be a physician at the time) to cover the football and other impact high school games in case of injuries. The loss of the people who make us rural hospitals would have an effect an the entire community."
What Happens Next
The bill that would push forward cuts to the Medicaid program needs to win over nearly every Republican on the floor of the narrowly divided House. If it passes, it will then be considered in the Senate.