House Republicans in Congress approved President Donald Trump's multitrillion-dollar tax breaks and spending cuts bill in a narrow vote Thursday, overcoming setbacks to pass Trump's signature second-term policy package before a Fourth of July deadline. To help offset the lost tax revenue, the package includes $1.2 trillion in cuts over 10 years to Medicaid and other social safety net programs.
But states and rural health advocacy groups warn that cutting Medicaid — a program serving millions of low-income and disabled Americans — would hit already fragile rural hospitals hard and could force hundreds to close, stranding some people in remote areas without nearby emergency care and other health services.
More than 300 hospitals could be at risk for closure under the Republican bill, according to an analysis by the Cecil G. Sheps Center at the University of North Carolina at Chapel Hill, which tracks rural hospital closures. Even as Congress haggled over the controversial bill, a health clinic in the southwest Nebraska town of Curtis announced Wednesday it will close in the coming months, in part blaming the anticipated Medicaid cuts. And while the bill includes a provision that will provide $10 billion annually to buttress rural hospitals over the next five years, many rural hospital advocates are wary that it won't be enough to cover the shortfall.
Rural hospitals brace for financial hits or even closure under Republicans' $1 trillion Medicaid cut.
How will the bill affect Medicaid funding in your state? You can use this interactive map to see estimates for how much federal Medicaid funding states will lose under the bill. The estimates are from a KFF analysis of figures from the Congressional Budget Office. KFF estimates in its analysis that some states could lose one-fifth of their federal Medicaid spending.
An embed code for the same interactive map can be found at the end of this guide.
Use this KFF fact sheet to see figures for the percentage of people covered by Medicaid in each state. And a separate KFF report shows 36 states losing $1 billion or more over 10 years in Medicaid funding for rural areas under the Republican bill.
— How much federal Medicaid funding is my state projected to lose under the bill?
— Are any rural hospitals in my state impacted by the Medicaid cuts? The Center for Healthcare Quality and Payment Reform keeps data on rural hospitals that can be a good starting point for sourcing.
— Are any rural hospitals planning on closing entirely due to the anticipated Medicaid cuts? If such closures happen, what would be the next closest hospital for people in that community? Are there any specific departments in rural hospitals at risk for closure that would have an impact — like labor and delivery units? mental health care beds?
— How many people in my state rely on Medicaid for healthcare and how will they be impacted by the bill? (The KFF fact sheet linked above is one resource for this.)
This AP digital embed map shows estimated cuts to federal Medicaid spending by state over the next decade, according to a KFF analysis of figures from the Congressional Budget Office based on the Senate version of President Donald Trump's tax and spending cuts package. This map is current as of July 2, 2025 and will not update. Source: KFF.