US Hospitals Cut Services After GOP Bill
U.S. hospitals have begun a wave of service cuts, facility closures, and layoffs following the implementation of the Republican-led "big beautiful bill." The resulting backlash, particularly in rural areas, is fueling political attacks from Democrats who are using the issue to rally their base ahead of the midterm elections.
The "big beautiful bill," officially titled the One Big Beautiful Bill Act (OBBBA), was signed into law on July 4, 2025. The legislation enacts significant cuts to Medicaid and other social safety net programs to offset tax cuts. The Congressional Budget Office estimates the healthcare provisions of the bill will lead to 11.8 million people losing their health coverage by 2034. The law is projected to slash federal Medicaid spending by an estimated $1.02 trillion. This has a disproportionate impact on rural hospitals, which often rely heavily on Medicaid reimbursements to remain operational. One analysis projects a $50.4 billion reduction in federal Medicaid spending for rural hospitals over the next decade. Across the country, over 700 rural hospitals are considered at risk of closure, with more than 300 at "immediate risk". States with the highest number of at-risk hospitals include Kansas, Texas, Oklahoma, Alabama, and Mississippi. In Kansas alone, 66 rural hospitals are facing potential closure. These cuts are not limited to hospital closures. Many facilities are being forced to reduce essential services. Obstetric care is frequently among the first services to be cut, increasing the number of "maternity care deserts" in rural areas. In New Hampshire, two rural health centers have already closed, and an Oregon hospital has shut down its obstetric ward, citing the new law as a contributing factor. To address these impacts, the bill established a $50 billion "Rural Health Transformation Program" to be distributed to states over five years. However, critics point out that this amount covers less than a third of the projected Medicaid cuts that rural communities will experience. The hospital service cuts and closures have become a major focus for Democrats heading into the midterm elections. They are highlighting the impact on healthcare affordability and access, which polling shows is a top concern for voters, including independents. Democrats have already blocked a government funding extension, demanding protections for healthcare programs in response to the OBBBA's cuts.
