The road to four struggling rural hospitals now hosts a political message: \u201cIf this hospital closes, blame Trump.\u201d<\/p>\n
In a series of black-and-yellow billboards erected near the facilities, the Democratic National Committee (DNC) seeks to tell voters in deep red states \u201cwho is responsible for gutting rural healthcare\u201d.<\/p>\n
\u201cUNDER TRUMP\u2019S WATCH, STILWELL GENERAL HOSPITAL IS CLOSING ITS DOORS,\u201d one sign screams. The billboards are outside hospitals in Silex, Missouri<\/a>; Columbus, Indiana; Stilwell, Oklahoma<\/a>; and Missoula, Montana.<\/p>\n The fate of rural hospitals has become a politically contentious issue for Republicans, as historic cuts pushed through by the GOP are expected to come into effect over the next decade. Trump\u2019s enormous One Big Beautiful Bill Act (OBBBA) cut more than $1tn from Medicaid<\/a>, the public health insurance program for low-income and disabled Americans, insuring more than 71 million adults.<\/p>\n \u201cWhere the real impact is going to be is on the people who just won\u2019t get care,\u201d said Dave Kendall, senior fellow for health and fiscal policy at Third Way, a center-left advocacy organization.<\/p>\n \u201cThat\u2019s what used to happen before we had rural hospitals \u2013 they just don\u2019t get the care because they can\u2019t afford it, and they can\u2019t get to the hospital.\u201d<\/p>\n In response to criticism, Republicans added a $50bn \u201crural health transformation fund<\/a>\u201d just before passage of the OBBBA. The fund is expected to cover about one-third<\/a> of the losses rural areas will face, and about 70% of the losses for the four hospitals where Democrats now have nearby billboards. The rural health fund provides money through 2030, while the Medicaid cuts are not time-bound.<\/p>\n That is already becoming a political football, as Democrats<\/a> argued in a letter that the money is a \u201cslush fund\u201d already promised to key Republican Congress members.<\/p>\n \u201cWe are alarmed by reports suggesting these taxpayer funds are already promised to Republican members of Congress in exchange for their votes in support of the Big, Ugly Betrayal,\u201d wrote 16 Democratic senators<\/a> in a letter to Dr Mehmet Oz, Trump\u2019s head of Medicare and Medicaid.<\/p>\n A billboard in Missoula, Montana. Photograph: DNC<\/p>\n \u201cIn addition, the vague legislative language creating this fund will seemingly function as your personal fund to be distributed according to your political whims.\u201d<\/p>\n Rural hospitals have been under financial strain for more than a decade. Since 2010, 153 rural hospitals<\/a> have closed or lost the inpatient services which partly define a hospital, according to the University of North Carolina Sheps Center for Health Services Research.<\/p>\n \u201cIn states across the country, hospitals are either closing their doors or cutting critical services, and it\u2019s Trump\u2019s own voters who will suffer the most,\u201d said the DNC chair, Ken Martin, in a statement announcing the billboards.<\/p>\n The OBBBA is expected to further exacerbate those financial strains. A recent analysis by the Urban Institute<\/a> found rural hospitals are likely to see an $87bn loss in the next 10 years.<\/p>\n skip past newsletter promotion<\/a><\/p>\n Sign up to This Week in Trumpland<\/p>\n A deep dive into the policies, controversies and oddities surrounding the Trump administration<\/p>\n Privacy Notice: <\/strong>Newsletters may contain info about charities, online ads, and content funded by outside parties. For more information see our Privacy Policy<\/a>. We use Google reCaptcha to protect our website and the Google Privacy Policy<\/a> and Terms of Service<\/a> apply.<\/p>\n after newsletter promotion<\/p>\n \u201cWe\u2019re expecting rural hospitals to close as a result \u2013 we\u2019ve already started to see some hospitals like, \u2018OK, how are we going to survive?\u2019\u201d said Third Way\u2019s Kendall.<\/p>\n A June analysis<\/a> by the Sheps Center found that 338 rural hospitals, including dozens in states such as Louisiana, Kentucky and Oklahoma, could close as a result of the OBBBA. There are nearly 1,800 rural hospitals nationally, according to the Kaiser Family Foundation<\/a> (KFF), a healthcare research non-profit.<\/p>\n That perspective was buttressed by the CEO of the National Rural Health<\/a> Association, Alan Morgan, who in a recent newsletter said 45% of rural hospitals are already operating at a loss.<\/p>\n \u201cWhen you remove $155bn over the next 10 years, it\u2019s going to have an impact,\u201d he said.<\/p>\n In the fragmented US healthcare ecosystem, Medicaid is both the largest and poorest payer of healthcare providers. Patients benefit from largely no-cost care, but hospitals complain<\/a> that Medicaid rates don\u2019t pay for the cost of service, making institutions that disproportionately rely on Medicaid less financially stable. In rural areas, benefit-rich employer health insurance is harder to come by<\/a>; therefore, more hospitals depend on Medicaid<\/a>.<\/p>\n But even though Medicaid<\/a> pays less than other insurance programs, some payment is still better than none. Trump\u2019s OBBBA cut of more than $1tn from the program over the coming decade is expected to result in nearly 12 million people losing coverage.<\/p>\n When uninsured people get sick, they are more likely to delay care, more likely<\/a> to use hospital emergency rooms and more likely<\/a> to struggle to pay their bills. In turn, the institutions that serve them also suffer.<\/p>\n