The calculations are now coming out that some 700 U.S. public hospitals (out of a total of 5,000 community hospitals) are at risk of shutdown, as of 2026 and thereafter, when cuts in Medicaid start to hit, as mandated for the next 10 years by the new One Big Beautiful Act from President Trump and Congress. These vulnerable hospitals, mostly rural, serve a large poor constituency, dependent on Medicaid to pay for doctors and hospitalization. If Medicaid is cut, very few of the hospitals will survive.
U. S. Health and Human Services Secretary Robert F. Kennedy, Jr. was down in Texas this week, to push his “Make America Healthy Again” (MAHA) remedy for the hospital crisis, under the banner of, “Strengthening Rural Health Care.” His message: If states pass “MAHA” laws requiring people to live and eat right, then the Feds will come up with some funds that might help keep a few hospitals open.
State by state, the at-risk hospitals are well known. For example, Texas has 15 at-risk hospitals; New York state has 29; Virginia has 7. These projections are done by agencies such as KFF, based in San Francisco, and the University of North Carolina, Shepps Center.
The public health principle involved in providing hospital care, in short, is that populations should have conditions available to them, according to their density of residence, in terms of hospital beds per capita, diagnostic and treatment equipment per capita, medical staff per capita, along with safe water, ample food, defense against pests, etc.
