Rural Health Information Hub Latest News

‘One Big Beautiful Bill’ Would Batter Rural Hospital Finances, Researchers Say

Cuts to Medicaid and other federal health programs proposed in President Donald Trump’s budget plan would rapidly push more than 300 financially struggling rural hospitals toward a fiscal cliff, according to researchers who track the facilities’ finances.

The hospitals would be at a disproportionate risk of closure, service reductions, or ending inpatient care, according to a report authored by experts from the Cecil G. Sheps Center for Health Services Research following a request from Senate Democrats, who released the findings publicly Thursday. Many of those hospitals are in Kentucky, Louisiana, California, and Oklahoma, according to the analysis.

Trump’s budget plan, dubbed the “One Big Beautiful Bill Act,” contains nearly $800 billion in Medicaid cuts, according to the nonpartisan Congressional Budget Office. House Republicans passed the bill in late May, and it now awaits Senate consideration.

The proposed cuts to Medicaid raise the stakes for rural hospitals nationwide, many of which already operate on razor-thin, if not negative, margins. Diminished reimbursements from the state-federal health insurance program for those with low incomes or disabilities would further erode hospitals’ ability to stay open and maintain services for their communities — populations with more severe health needs than their urban counterparts.

“It’s very clear that Medicaid cuts will result in rural hospital closures,” said Alan Morgan, CEO of the National Rural Health Association, a nonprofit advocacy and research organization.

The Senate Democrats sent a letter to Trump, Senate Majority Leader John Thune, and House Speaker Mike Johnson asking them to reconsider the Medicaid cuts.

Sen. Edward Markey (D-Mass.), one of the Senate Democrats who requested the information from Sheps, in a statement said communities should know exactly what they stand to lose if Congress approves the reductions to Medicaid.

“People will die” if rural hospitals close, he said. “No life or job is worth a yes vote on this big billionaire bill.”

Read more.

PHAN Publishes Report on Vulnerable Hospitals in Pennsylvania

Some hospitals are operating on a razor-thin margin. Any disruption can lead to the elimination of services or complete closures. With declining Medicare reimbursement and cuts to Medicaid, uncompensated care will increase and budgets will not be sustainable.  Over the past 25 years, Pennsylvania has seen 78 closures or reductions in core services statewide, 26 of which were in rural counties. The Pennsylvania Health Access Network (PHAN) has identified eight criteria that describe a hospital’s likelihood to be impacted should cuts or changes to the Medicaid program occur.

View the report.

Medicaid Provisions Tracked in the House Bill

KFF is tracking health-related provisions of the 2025 Federal Budget Reconciliation Bill passed by the House, specific to Medicaid, the Affordable Care Act, Medicare, and Health Savings Accounts. The summary highlights sections of the House bill and compares changes to the current law. Of note, as it is currently drafted, the timeline for many of the provisions to take effect, if passed, would be enacted immediately, with others beginning as early as Jan. 1, 2026.

Departments of Labor, Health and Human Services, Treasury Announce Move to Strengthen Healthcare Price Transparency

The federal departments of Labor, Health and Human Services, and the Treasury took action to advance President Trump’s directive to ensure Americans have clear, accurate, and actionable information about healthcare prices. The departments jointly issued a Request for Information (RFI) seeking public input on how to improve prescription drug price transparency. The agencies also released updated guidance for health plans and issuers that sets a clear applicability date for publishing an enhanced technical format for disclosures.

These improvements are designed to eliminate meaningless or duplicative data and make cost information easier for consumers to understand and use. Separately, CMS released new guidance, available on the Hospital Price Transparency resources website, to strengthen the Hospital Price Transparency requirements, requiring hospitals to post the actual prices of items and services, not estimates. CMS also issued its own RFI to gather public feedback on how to boost hospital compliance and enforcement and ensure data shared is accurate and complete. See the full press release for more information.

MAHA Commission Releases First Report on Childhood Health

On May 22, the Presidential Commission to Make America Healthy Again (MAHA) released its report on childhood chronic disease, per the President’s executive order in February. The “Make Our Children Healthy Again Assessment” report details potential drivers of childhood chronic disease in America: improper diets, environmental toxins, reduced physical activity levels, high chronic stress levels, and increased use of pharmaceuticals. Notably, this section also includes information on childhood vaccines and argues that the vaccine schedule has grown rapidly without sufficient guardrails or nuanced debate.

The assessment calls for the National Institutes of Health, the Food and Drug Administration, and the Centers for Medicare and Medicaid Services to close research gaps in children’s health; bolster pediatric drug safety monitoring; utilize artificial intelligence to provide real-time surveillance; invest in alternative testing models; and expand data initiatives, like the NIH-CMS autism data initiative, to study childhood chronic diseases.

The MAHA Commission will now work to create the Make Our Children Healthy Again Strategy based on the report’s findings, with publication due in less than 80 days. Following the report’s release, RFK Jr. released a statement on May 27 that the CDC will no longer recommend the COVID-19 vaccine for “healthy” children and pregnant women.

Millions For Public Wi-Fi in Pennsylvania Cut

Pennsylvania will lose out on more than $35 million in federal funding to expand high-speed internet access after the Trump administration abruptly canceled two grant programs that were part of former President Joe Biden’s push to bring broadband to everyone in the U.S. The move came shortly after President Donald Trump declared the underlying law “racist” and “wholly unconstitutional” in a social media post in early May. The funding was created by the Digital Equity Act, part of the sweeping infrastructure package that passed Congress with bipartisan support in 2021. The decision affects more than $2.5 billion in grants to states, as well as local governments, nonprofits, and universities