Cuts to Medicaid leave rural hospitals across the nation at risk of closure. (Courtesy of Wikimedia Commons)

Following the recently passed federal tax bill, 338 rural hospitals across the nation, including four in Oregon, may now be at high risk of closure due to new budget cuts to Medicaid.

According to a June statement from Oregon Sens. Ron Wyden and Jeff Merkley, rural hospitals in Silverton, Seaside, Madras and Hermiston are at high risk of closure due to “Republican health care cuts.”

However, Lisa Goodman, communications vice president at the Hospital Association of Oregon, neither confirmed nor backed these statements from the senators regarding hospital closures in Oregon.

“We were not involved in the development of that report or its methodology. It is unclear to us how these four hospitals were identified as being the most vulnerable. We do not think reports like this are accurate or helpful,” Goodman said in a statement. “More broadly speaking, we can say that federal changes resulting from H.R. 1 will have devastating impacts on Oregon’s health care landscape and we are committed to working with the state and partners to find a path forward.”

Legacy Silverton, the main hospital in Silverton, declined to issue a statement in response to the senators’ report.

The “One Big Beautiful Bill Act,” signed July 4, is set to reduce Medicaid spending by roughly $1 trillion over the next decade, pushing rural hospitals that rely on this funding system toward the brink.

While the exact hospital closures in Oregon may be unclear, it is expected that this new law will lead to a rise in unpaid medical care that hospitals will now have to foot the bill for — leading rural hospitals to contemplate changing or eliminating certain services, delaying the purchasing of new equipment and laying off staff.

Though these new budget cuts raise alarms to many small communities and hospitals across the nation, many rural hospitals have been struggling for years.  Over the past decade there has been a decline in critical services such as inpatient and obstetric — pregnancy, childbirth and postpartum — services. In 2024, rural hospitals saw a 16% decline in hospital-based obstetric care services, with Medicaid paying just 63 cents on the dollar for care provided to Medicare patients, according to the American Hospital Association.

What Medicaid can’t cover in a patient’s fees, the hospital has to pay for.  Nearly half of rural hospitals across the U.S. operated at a loss in 2023, with over 90 hospitals unable to provide overnight patient care over the last decade or having to shutter entirely, according to the AHA.