Letter: Rural hospital systems are facing a perfect storm

Dear Editor,

The Affordable Care Act enhanced tax credits are set to expire. Premiums will skyrocket.

The Budget Bill (July 2025) will cause extensive Medicaid cuts. The Kaiser Family Foundation (KFF) estimates that federal Medicaid spending in rural areas could drop by approximately $137-$155 billion over ten years and cause 10 million people to lose health insurance. Hospital systems will lose revenue.

The Budget Bill triggers mandatory cuts to Medicare estimated to be over $550 billion. Seniors and the disabled are already facing higher premium costs.

The Rural Health Transformation Act allocates $50 billion to offset state Medicaid expenses. It will not help ACA or Medicare recipients who cannot afford insurance. The impact of these changes on rural areas and the extent to which the rural health fund offsets Medicaid losses will vary across the country (KFF, August 2025).

Rural health care is affected by other factors such as the loss of physicians and nurses, as new H-1B visas will cost more than hospital systems can afford. Patients will avoid care until it is catastrophic, causing higher costs for care.

Rural hospital systems are facing a perfect storm. It will take time to develop and evaluate new programs to meet government criteria for Medicaid patients. Meanwhile, ACA and Medicare patients will avoid seeking care. The result will be disruption and healthcare system closure in rural communities.

Sincerely,

Debra Jones

Apalachin, New York