WASHINGTON – Americans living in rural communities across the country may have reduced access to health care if Congress changes Medicaid eligibility or significantly cuts federal funds.

Dependent country residents National federal programs for low-income people You will experience the most impact. Those who have private health insurance or have other coverages like Medicare will likely encounter changes.

Experts say that if Medicaid patients are unable to pay for the same level of health care, then Medicaid patients will not be able to pay for the same level of health care, leading to reduced services offered to all, could lead to a reduction in the income of rural hospitals and primary care physicians.

Whitney Zand, an assistant professor at the University of Iowa’s Department of Health Management and Policy, said Medicaid cuts would “clash with rural communities disproportionately.” There, 24% of people cover the program.

“This has more impact on them than urban people, and it’s added to the older population, where there’s already less access to care and more need for care,” Zand said. “It’s just making something already challenging even more challenging for the rural community.”

Federal Bureau of Rural Health Policy I’ll classify it Based on 2020 census data, about 20.3% of Americans living in rural areas, or 62.8 million.

Closure of rural hospitals in America

In rural areas, hospitals are watching doors close at higher rates than non-rural facilities, and that trend doesn’t seem to be reversed anytime soon.

Cecil G. Sheps Health Services Center Research Center, University of North Carolina Chapel Hill Interactive map It shows 87 rural hospitals have been completely closed since 2010, but another 65 “we no longer provide hospitalization services, but we continue to provide healthcare services.”

And a Report The Healthcare Quality and Payments Reform Centre, released in February, shows that “more than 700 rural hospitals, more than a third of all rural hospitals in the country, are at risk of shutting down due to the serious financial problems they are experiencing.”

Losing revenue from Medicaid patients could lead to a “domino effect,” Zahnd said, adding that it could exacerbate budgetary challenges for rural healthcare providers and potentially community-wide, making them a potential challenge overall.

“Economically in many rural communities, hospitals are the biggest employer,” Zand said. “So if the hospital is nearby, people may not only be losing access to health care, but they may be losing their jobs or their families may be losing their jobs.”

Rural healthcare providers who can stay open may need to cut down on the services they provide to ensure their accounts do not turn too red. Such decisions not only harm Medicaid patients, they also harm those living in rural communities who go to the hospital.

“So these are some of the risks we would expect if Medicaid had these big cuts,” Zahnd said.

Winners and losers

Timothy McBride, co-director of the Center for Health Economics and Policy at the Washington University Institute of Public Health in St. Louis, Missouri, said during a Medicaid briefing in mid-March that the financial margins at rural hospitals were “a thin razor.”

“Even in urban hospitals, they are probably just a few percent points, but in rural hospitals, they can be just points or two or negative,” McBride said. “So if they take away the Medicaid dollars, they’ll certainly be in negative light. And if you’re wondering why rural hospitals are closing, that’s why.”

McBride also insisted on March 13th. Briefings sponsored by Scilinea service for journalists and scientists based in the American Association for the Advancement of Science, and Medicaid funds many rural healthcare providers.

“In the economic system, if we cut our spending, we’ll say, ‘Oh, that’s great. We’ll cut $880 billion.” But who’s income? “And that’s really difficult in rural systems, rural hospitals and urban systems.

“Yeah, that’s going to help taxpayers, but keep in mind, you know, who’s going to hurt. There are winners and losers here.”

Budget Process

Congressional Republicans plan to use it A complex budget adjustment process The new deficit has slumped into a surge of around $4.5 trillion in order to extend the 2017 tax cuts enacted during President Donald Trump’s first term. They also want to increase spending on defense and border security in hundreds of billions of dollars and rewrite their energy policy.

To pay for a portion of the package, House of Representatives budget resolution We direct the committee overseeing Medicaid to cut spending by $880 billion over the next decade. These are the numbers quoted by McBride.

Senate Republicans have yet to agree to the outline and have expressed some concerns about how sudden cuts in federal funding will affect their members.

Census data shows that over 85% of the US remain rural. That is, all of the 53 Republican senators represent states with at least some rural areas.

The Senate is expected to discuss budget resolutions for the House of Representatives for the coming weeks. Voted along the party line to approve in February. The senator is likely to make changes across the house and send them back to get final approval.

If two chambers vote to adopt the same budgetary resolution with the same settlement order, Congress can formally begin moving forward with legislation that can restructure Medicaid. However, GOPs need to continue to unite throughout the process.

Republicans hold a paper majority in the House of Representatives, demanding that proposed changes to Medicaid win the support of centralists and far-right GOP lawmakers.

Even a Medicaid change, or some asylum for other elements of the bill, would stop the package from becoming law.

Avoid high medical costs and bankruptcy

Joan Alker, executive director of the Center for Children and Families at Georgetown University, said in addition to the “critical backbone of our healthcare system,” Medicaid will help prevent low-income Americans from entering medical debt and reduce the number of people landing in the emergency department due to conditions that primary care providers can manage.

“Of course, I spend a lot of time on Medicaid and access issues, but basically, Medicaid is financial support. It’s an important part of the puzzle for families struggling to pay bills with high housing and food costs,” Alker said. “And that’s the most important thing. If you’re uninsured in this country, unless you’re a billionaire, you’ll be exposed to high medical costs, which can lead to debt and even bankruptcy.”

When people lose access to health insurance and programs like Medicaid, they tend to be delayed, avoiding going to primary care providers who can diagnose problems early or help patients manage their chronic conditions.

“That’s not the way we want our healthcare system to work,” Alker said. “Their condition gets worse. They didn’t have access to the prescription medications they needed to deal with chronic diseases like asthma and diabetes and high blood pressure.

Medicaid also covers healthcare for about half of US children and over 40% of births, and the program has become a major source of income for both pediatricians and Obgyns. If patients lose access to the program, they will see budgets drop.

“There are already challenges and these kinds of cuts really make those worse for families living in these communities, whether they’re registered with Medicaid or not,” Alker said.

The whole community was affected

Megan Cole, an associate professor at the Department of Health Act, Policy and Management at Boston University School of Public Health, said during a Syline briefing that if Congress cuts Medicaid it would have a wide-ranging impact on rural healthcare.

“I think these reductions will affect Medicaid recipients as well as the entire economy and healthcare system. So, especially the safety net health system, community health centers, rural hospitals,” Cole said. “Because these institutions have low patient incomes, they may face a decline in services. They may close certain sites depending on their finances, and they may eliminate staff.

Last updated at 10:41am, March 21, 2025