Medicaid cuts threaten hundreds of hospitals, new report finds
Together, the hospitals provide care for nearly 7 million patients across the U.S., according to the analysis.
Across the country, hospitals have already warned they may need to lay off staff members or scale back care, including maternity and mental health care, because of Medicaid cuts.Image Source / Getty Images
More than 400 hospitals across the United States are at high risk of closing or cutting services because of the Medicaid cuts in President Donald Trump’s “big, beautiful bill,” according to an analysis from the progressive watchdog group Public Citizen.
The fallout could make it harder for millions of people to get care and put thousands of health care workers’ jobs at risk as hospitals lose a key source of federal funding. Medicaid covers about a fifth of all hospital spending.
The Medicaid cuts come in phases, with more significant changes, including work requirements, in 2027 and limits on how states raise funds in 2028. Overall, the law is expected to reduce federal Medicaid funding by roughly $1 trillion over the next decade.
“We’re seeing hospitals that are already under severe financial strain having to make decisions about how to stay financially solvent,” said Eileen O’Grady, a researcher in Public Citizen’s Congress Watch division and the report’s author. “That has pretty clear implications for people who live in that community. It also has ripple effects on other hospitals in those communities.”
The analysis draws on hospital financial data from the Centers for Medicare and Medicaid Services from 2022 through 2024, covering about 95% of U.S. hospitals. The group defined at-risk hospitals as those in which Medicaid and other low-income government programs made up at least 20% of revenue and that have been operating at a loss in recent years.
The report doesn’t estimate when hospitals could close or cut services.
“Closure is the worst-case scenario, but it also doesn’t preclude hospitals from having to make really tough decisions about cutting services that might be essential to those communities but are just no longer financially viable,” O’Grady said.
Across the country, hospitals have already made statements warning they may need to lay off staff or scale back care, including maternity and mental health care, because of the Medicaid cuts.
For many patients, hospitals are the last place to turn when there are few or no other options for care.
“When hospitals close, patients have less access to the care that they need,” said Gideon Lukens, director of research and data analysis on the health policy team at the Center on Budget and Policy Priorities, a nonpartisan research group. “They have to travel further or wait longer in other hospitals that become overcrowded. That additional time can be the difference between success and failure of time-sensitive, potentially life-saving treatments.”
The closures also add strain to the hospitals that take on the extra patients. O’Grady said doctors end up having “less patience, less time, less capacity to provide the highest quality care.”
“It can be very dangerous for hospitals to be under this kind of strain,” she said.
The analysis found a total of 446 at-risk hospitals, with at least one at-risk hospital in 44 states and Washington, D.C.
About 60% of the at-risk hospitals — 267 facilities — are in urban areas, even as much of the debate around Medicaid cuts has focused on rural hospitals. Black and Latino people stand to be the most affected by the cuts.
The hospitals span both Democratic and Republican-led states, though the states with the largest number of at-risk hospitals are California, New York, Illinois and Washington.
Republicans also represent several congressional districts with the highest number of at-risk hospitals. House Republicans who voted for the Medicaid cuts have 196 at-risk hospitals in their districts, while Senate Republicans — all of whom back the cuts — represent 146 at-risk hospitals in their states, according to the analysis.
The cuts could lead to a worsening crisis, especially for rural hospitals, said Zachary Levinson, the project director of the KFF Project on Hospital Costs.
He said that by his estimates, Trump’s law sets aside $50 billion to support rural communities, but could reduce federal Medicaid spending in rural areas by far more — about $137 billion over a decade.
James Jackson, the CEO of Alameda Health System in Oakland, California, said the Medicaid cuts represent an “existential threat.”
Alameda Health System, which gets 60% of its revenue from Medicaid payments, announced in December that it would lay off nearly 300 employees and lose more than $100 million annually by 2030. (The health network was not included on Public Citizen’s at-risk list, though the report notes its financial troubles.)
The layoffs, set to take effect in March, have since been delayed.
Proposed cuts included mental health services, care for patients with chronic conditions and an ambulatory plastic surgery program. Jackson said closing hospitals is not on the table, but the system has continued to look at scaling back services.
“I don’t think the impact is going to be a positive one,” he said. “We are often the provider of last recourse, so if we’re not able to provide a service, there will be a delay in receiving care at one of the other systems in the area or they may not provide it at all.”
Trinity Health, a Michigan-based hospital system with facilities in other states, said it’s projected to lose $1.5 billion due to “recent and future government policy changes.”
In January, it said it was laying off 10.5% of its billing staff. One of its hospitals, St. Mary’s Sacred Heart Hospital in rural northeast Georgia, announced last October it was closing its maternity unit.
In a statement, a Trinity Health spokesperson shared a previous statement that said in part that “more reductions” are being considered by the federal government and it’s “not possible to simply absorb such a significant financial impact without making thoughtful, forward-thinking changes.”
Berkeley Lovelace Jr. is a health and medical reporter for NBC News. He covers the Food and Drug Administration, with a special focus on Covid vaccines, prescription drug pricing and health care. He previously covered the biotech and pharmaceutical industry with CNBC.
tRump claims he would let any country send oil to Cuba. That is not true. Canadawanted to send supplies and oil and tRump threatened them to back down. Mexico was going to supply oil to Cuba and tRump threatened to destroy the ships and attack Mexico, so they backed down. But when Putin sent oil, tRump totally ignored it and claimed to have wanted it. I do not know what Putin has on tRump but it has to be more than the Epstein files. It has to be something that could totally ruin him, his father, and his kids. Also Russia is openly helping Iran and yet tRump removed the oil sanctions to give them more money to continue to batter Ukraine while tRump stopped direct shipments of military supplies needed by Ukraine some time ago. The Europeans picked up the slack by buying the US military arms to send to Ukraine themselves. tRump is now refusing to honor the 750 million dollars worth of paid for orders of these countries to instead send the arms to the Middle East. Again what does Putin have on tRump and so many in our congress? Hugs.
In February 2026, a rumor spread that Bo French, a Republican candidate for the Texas Railroad Commission, which regulates oil and gas, wanted to deport Native Americans — people indigenous to the U.S. Several social media posts made the claim, including on Facebook, where one user said French had called for the deportation of “third world savages” including Native Americans.
Some posts linked to a Feb. 10, 2026, article in Texas Monthly, which included a line that read, “One of French’s favorite phrases is ‘third world savages’—which he has applied to Afghan asylum seekers, Muslims, and even Native Americans, who he also wants deported.” It is true that French called for the deportation of Native Americans. He did so in an Oct. 10, 2025, post on X.
Read the full article. French, who is allied with two far-right Christian nationalist fracking billionaire pastors, last appeared here in November 2024 when he declared that Democrats are “retarded unmanly homos.” He appeared here in September 2024 when he lost a court battle to ban early voting on college campuses.
A former instructor for U.S. Immigration and Customs Enforcement on Monday accused the agency of dramatically slashing training standards for new officers and lying to Congress about it as the Trump administration seeks to rapidly expand its mass deportation operation.
Ryan Schwank, who resigned from his job at an ICE academy in Georgia last week, told congressional Democrats at a hearing that the agency eliminated 240 hours of “vital classes” from a mandatory 580-hour training program, including instruction about the legal boundaries for the use of force, how to safely handle firearms, and the proper way to detain and arrest immigrants.
“Law enforcement is a deadly serious biz. It is not a place for shortcuts,” Schwank said. “Deficient training can and will get people killed. … ICE is lying to Congress and the American people about the steps it is taking to ensure that 12,000 officers can faithfully uphold the Constitution and perform their jobs.”
Ryan Schwank, a former ICE academy instructor, testified in front of Congress today about constitutional violations.“At the academy, we took out the class that tells the officers that they have an oath to the Constitution.”
Former ICE agent: My first day training new cadets, I received secretive orders to teach them to violate the Constitution by entering homes without a warrant. I watched ICE cut classes that teach our legal system, firearms training, use of force, lawful arrests, and the limits of officers' authority
Former ICE trainer Ryan Schwank is telling Congress that agents are being trained to ignore the Constitution. "I swore an oath to uphold the Constitution when I joined ICE. I followed it when I resigned. The legally required training program at the ICE academy is deficient, defective, and broken."
Director Lyons looked me in the eyes and said ICE was receiving proper training.Now a whistleblower says officials are lying about how much training new recruits actually get.They’re cutting corners and covering up. We need real answers and accountability. http://www.cbsnews.com/news/ice-whi…
This person Same is interviewing is from the Cato Institute. Sam and David talk about the bigotry and attempt to purify the country of non-white people. tRump and his racist administration claim to want to remove 100 million from the US. There is no where near that number of undocumented people in the country. That number is almost 1/3 of the US population. Undocumented immigrants were estimated at 14 million in 2023 at the highest. So where are the rest of these people coming from? Legal documented immigrants and non-white citizens born in the US. That is why they are rounding up brown people who immigrated here legally and why they are trying so hard to end birth right citizenship. The goal has become clear and it is scary to me. To cement the white majority for as long as possible and stop the slow decline of the white majority / rize of minority demographics. Stephen Miller and the other racists in tRump administration want an apartheid state like the former South African one was. They want no rights for non-whites. They want no non-whites in positions of authority. The administration is going after businesses and higher education for not prioritizing whites over any other group. They feel no white male is less qualified than any non-white. If a non-white person scored 95 and the white person scored 75, these racists feel the white person is still more qualified because of their skin color. The racists feel the only DEI that should be allowed is the promotion of white males over everyone else. Hugs
The game plan is clear and was used to accomplish the genocide of the LGBTQ+ from society in Russia. Attack the most vulnerable and smallest members of the LGBTQ+ trans people in the name of saving the most vulnerable, who are the little children espcailly little girls / daughters. Every study proves that the ones in real danger or under threat are not the kids but the trans people. Then use the momentum and rising bigotry to remove all rights and equality from the rest of the LGBQ+ based on the same lies. End goal is to create a straight cis country where the Christian white male is making the country safe / regressive enough for their bigoted view of Jesus to feel comfortable enough to return and pat them on their heads. Hugs
The Idaho Senate has widely passed a bill that would fine local and state governments for flying flags that aren’t on the Legislature’s pre-approved list.
The bill’s House sponsor, Rep. Ted Hill, an Eagle Republican, has said House Bill 561 is meant to target the city of Boise for flying an LGBTQ+ pride flag. Boise’s City Council voted to declare the pride flag and the organ donor flag as official flags, in an apparent move to work around the Legislature’s flag ban law passed last year.
The bill would add a $2,000 daily fine, per offending flag, to the flag ban law from last year, which lacked an enforcement process. The bill widely passed the House earlier this month. But since the Senate amended the bill, it must return to the House before it would go to Gov. Brad Little for final consideration.
Rep. Ted Hill [photo] appeared here yesterday for his successful bill that criminalizes using the “wrong” bathroom. Violating that law would be a misdemeanor punishable by up to one year in prison. A second offense within five years would be a felony, carrying up to a five-year prison sentence.
Hill appeared here in 2024 for his successful bill banning teachers from referring to students with their preferred pronouns.
Earlier this month, the Idaho House passed a resolution to petition the US Supreme Court on overturning Obergefell.
In February, the Idaho House advanced a bill to overturn all local LGBTQ rights ordinances statewide. Thirteen Idaho cities and counties, including Boise and its home county, have such laws on the books.
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