A Protect Our Care Initiative
Republicans are closing hospitals, clinics, and nursing homes to pay for tax cuts for billionaires.
Interactive map of facilities at risk
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The crisis, community by community
Donald Trump and Congressional Republicans passed the largest health care cuts in American history — slashing Medicaid and the Affordable Care Act (ACA) to hand tax breaks to the wealthiest corporations and individuals in the country. The bill they called "beautiful" is devastating communities across every state.
Hospitals are closing labor and delivery wards. Nursing homes are locking their doors. Rural clinics, community health centers, and specialty care facilities that serve seniors, people with disabilities, and families with no other options are disappearing.
These are real facilities — hospitals, clinics, nursing homes, wards, and care centers — real communities, and real consequences. With Hospital Crisis Watch, we're tracking every closure, every cut, and every community left behind after Donald Trump and Republicans in Congress gutted American health care to bankroll tax breaks for billionaires.
Crisis statistics breakdown
Latest news roundups
Our team scans hundreds of news sources every day. Every week, we publish a roundup of the most significant coverage — the stories Republicans hope you won't see.
Local news tracker
The national story is made of thousands of local ones. Here's what journalists across the country are reporting — state by state, community by community. Updated continuously by our team.
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Understanding the full scope of the crisis
Common questions about H.R. 1, the Medicaid cuts, and how this crisis is unfolding in real time.
Will the "Rural Health Transformation Fund" blunt the damage?
No. "It is highly unlikely that any state will receive more money from the rural health fund than it will lose from the historic cuts to federal funding for health care in the 2025 reconciliation law and from other federal policy changes," according to KFF.
H.R. 1 does deep damage to rural health care that the "rural health transformation fund" does not even begin to make up for. The cuts are shuttering hospitals, leaving expecting mothers more than an hour away from care, and throwing rural communities into a tailspin. Over 330 rural hospitals are at risk of cuts or closure after Republicans gutted over $130 billion from rural health care.
The $50 billion pity fund did not come close to making up for the cuts. To make matters worse, the Trump administration dictated less than 15 percent could be used to help rural hospitals keep their doors open. Jed Hansen, the executive director of the Nebraska Rural Health Association, said "Rural Health Transformation will not save a single hospital in our state. I don't think it will save a single hospital nationally."
Aren't the deepest cuts delayed until 2027 and 2028?
Hospitals are already being forced to cut services, close wards, and shutter entirely based on their projected losses from work requirements, cuts to provider taxes, and cuts to state-directed payments. States have already begun to cut Medicaid provider reimbursement rates in anticipation of deeper federal funding cuts.
Many hospitals, especially rural hospitals, operate on extremely slim margins. Over 45 percent of rural hospitals are already operating with negative margins. Medicaid funding and changes in reimbursement make or break their survival. The closures we're seeing are just the beginning. The crisis will only escalate in 2027 and 2028.
Are rural health closures part of a historic trend?
Rural health facilities have always had a hard time surviving and received major relief when Medicaid was expanded under the ACA. Medicaid pays for a fifth of rural hospital patients, half of all births in rural areas, and 6 in 10 nursing home residents.
Instead of expanding Medicaid, Republicans poured gas on the flames of the rural health care crisis by cutting over $1 trillion from the program, all to pay for tax breaks for billionaire donors and corporations. Researchers estimate H.R. 1 will rip away over $660 billion from hospitals over the next decade. 92 percent of hospital leaders expect a significant financial impact.
Now, facilities are shuttering across the backyards of Republicans in Congress who voted to gut Medicaid — and they are cruelly trying to deflect the blame.
What do recent policy changes have to do with physician shortages?
Republican policy changes are exacerbating the nationwide physician shortage and making it harder for hospitals to stay staffed and keep their doors open.
H.R. 1 slashed student loan programs and made it prohibitively expensive for people from rural areas to become doctors and serve their communities. The Trump administration's visa policies are stopping providers who are likely to serve rural communities from entering the country. The Trump administration's FY2027 budget proposal calls to slash $872 million from health care workforce programs.
When hospitals cite "financial pressures," "uncertainty," or other reasons, how is that connected to the Medicaid and ACA cuts?
Hospitals are estimated to lose over half a trillion in revenue over the next decade due to cuts to Medicaid and billions in revenue from cuts to the ACA. As millions of Americans lose coverage, they will still need health care — and without health coverage, they will rely on hospitals to cover their costs. Hospitals are already seeing a rise in uninsured patients.
Though other financial pressures do exist, cutting Medicaid by $1 trillion only makes handling those challenges worse.
Hospitals and clinics often use euphemisms such as "increasing financial pressures," "uncertainty," "changing landscape," and "among other factors" rather than calling out Medicaid cuts directly when they are in desperate need of help and want to avoid placing blame on lawmakers who hold the purse strings. They are under immense pressure to politically please the state and federal lawmakers weighing policy, tax, and budget decisions that will affect their ability to survive.