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healthcare
Trump’s Budget Cuts Will Only Make Things Worse for Struggling Rural Hospitals
The budget bill will put enormous strain on rural hospitals, which are often the largest local employer in addition to crucial care providers.
Sep 14, 2025
Bari Senecal waits outside the emergency department at Columbia Memorial Hospital in Hudson, New York. “I do construction. I fell three stories,” Senecal explains. “I was on top of the scaffold and this new kid we hired didn’t put the braces on correctly.”
Like 70 million Americans, Senecal qualifies for Medicaid, the state and federally-funded public health insurance program for low-income patients. She also qualifies for Medicare. She’s what’s known as being “dual-eligible.”
At Columbia Memorial, 63% of patient service revenue is reimbursed through a combination of the two programs. But “we run a deficit every year,” says Dorothy Urschel, CEO of Columbia Memorial Health. “For many, many years, we’ve been reimbursed at well below cost.”
The hospital has the only emergency room serving the more than 110,000 residents scattered among two predominately rural counties. “Of course, we’re struggling,” says Urschel. “But rural community hospitals always struggle.”
Columbia Memorial already closed its maternity ward in 2020—part of a distressingly common trend. A recent study from the Journal of the American Medical Association found that more than half of rural counties now have no hospital-based obstetric services whatsoever.
Like other rural hospitals across the country, Columbia Memorial is bracing for the loss of Medicaid-covered patients and funding because of the Republican reconciliation bill, dubbed the “One Big Beautiful Bill Act,” which was signed by US President Donald Trump this summer.
Over the last decade more than 100 rural hospitals have closed across the country—50 of them in just the last eight years.
According to the nonpartisan Congressional Budget Office, the bill will cut $911 billion in federal Medicaid spending over the next decade and result in an estimated 10.3 million people losing their Medicaid health insurance. Add in cuts to the Affordable Care Act and the number of people expected to lose their insurance rises to 16 million.
According to Larry Levitt, vice president for health policy at the Kaiser Family Foundation, this amounts to “the biggest rollback in federal support for health coverage ever.” And it will put enormous strain on rural hospitals especially—which in Columbia County and elsewhere are often the largest local employer in addition to crucial care providers.
The GOP staggered these cuts so that the worst effects of the budget changes won’t be felt until after the midterm elections in 2026 are safely past. But “some rural hospitals around the country have already started closing” in anticipation of the cuts, warns Michael Chameides, a member of the Columbia County Board of Supervisors.
Senator Ed Markey (D-Mass.) provided a list of 338 rural hospitals in danger of either closing or drastically scaling back services. All 338 had experienced three consecutive years of negative total profit margins and were in the top 10% of institutions with patients on Medicaid.
Rural hospitals facing disaster are identified individually according to which state will see the losses. Kentucky, Louisiana, and California top the list with 35, 33, and 28 rural hospitals identified as at risk of closure, respectively. New York has 11. (Columbia Memorial isn’t officially one of them, but Garnet Medical Health Center Catskills, another Hudson Valley hospital, is.)
An estimated 1,796 hospitals remain in rural America, but those numbers obscure the level at which the services they offer may have already contracted. According to the Government Accountability Office, over the last decade more than 100 rural hospitals have closed across the country—50 of them in just the last eight years.
In New York and every other state, as federal funding runs dry it will be up to the governor and legislature to make provisions for struggling rural hospitals—or stand by and watch them collapse.
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US Court Lets GOP Defunding of Planned Parenthood Take Effect
"This cruel decision will disproportionately impact people of color and people living in rural communities and healthcare deserts," said one abortion rights activist.
Sep 12, 2025
A federal appeals court on Thursday gave the Trump administration the green light to cut off Planned Parenthood from receiving funding from Medicaid.
As reported by Reuters, the 1st US Circuit Court of Appeals placed a hold on a preliminary injunction granted by a lower court that had kept Medicaid funding to Planned Parenthood in place. Planned Parenthood was blocked from receiving Medicaid funding after US President Donald Trump signed the so-called "One Big Beautiful Bill Act" into law earlier this year.
In a statement released after the ruling, Planned Parenthood said that it would result in more than 1.1 million patients being unable to use Medicaid to access needed healthcare services at its clinics.
"Patients who rely on the essential healthcare that Planned Parenthood health centers provide, can’t plan for their futures, decide where they go for care, or control their lives, bodies, and futures," said Alexis McGill Johnson, president and CEO of Planned Parenthood Federation of America. "All because the Trump administration and its backers want to attack Planned Parenthood and shut down health centers."
Johnson added, however, that she wasn't giving up and said that Planned Parenthood "will continue to fight this unconstitutional law, even though this court has allowed it to impact patients."
Brittany Fonteno, president and CEO of the National Abortion Federation, warned that taking away funds from Planned Parenthood would only put more strain on other hospitals and clinics that are already bracing for the negative impact of the GOP's Medicaid cuts.
"When Planned Parenthood health centers are forced to close, pressure mounts on other clinics already stretched thin to provide sexual and reproductive health services," she said. "This cruel decision will disproportionately impact people of color and people living in rural communities and healthcare deserts, who will be left with even fewer options and longer wait times to get the care they need. Any additional barriers to care are both unacceptable and dangerous."
Sen. Elizabeth Warren (D-Mass.) took to social media to warn that up to 200 Planned Parenthood clinics could close thanks to the loss of Medicaid funding, which she said would have devastating consequences for women's healthcare.
"How many people will be denied cancer screenings, birth control, and STI testing?" she asked. "Millions. It's horrific."
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With Premiums Set to Rise, a Reminder: 'Medicare for All Would Save $650 Billion' Annually
"Your periodic reminder that health insurance is not healthcare," said one advocate. "It's an unnecessary middleman designed to restrict access to healthcare and exploit people for profit."
Sep 12, 2025
Health insurance premiums are set to skyrocket in the coming months, which has prompted many progressive advocates to remind Americans that a less expensive alternative is possible.
As The Washington Post reported on Friday, the cost of health insurance is "on track for their biggest jump in at least five years" thanks in part to the actions of congressional Republicans and President Donald Trump.
Citing new research from KFF, the Post noted that most people who buy insurance through the Affordable Care Act are set to see their premiums rise by over 75% unless Congress steps in and renews enhanced subsidies that had been passed into law under the American Rescue Plan in 2021.
Congressional Democrats have said that they will not vote to fund the government past its current rapidly approaching deadline unless Republicans in Congress agree to an extension of the enhanced health insurance tax credits.
The Post report also pointed to Trump's trade war threats as a justification being cited by insurers to raise rates. Even though Trump has yet to actually levy tariffs on pharmaceutical imports, his Commerce Department is currently investigating their impact and the president himself has said that the tariffs could be as much as 250%.
"Some insurers, in legal filings with regulators, have said explicitly that the expected tariffs were raising insurance prices," the paper explained. "A document from United Healthcare of New York states that, to account for 'uncertainty regarding tariffs and/or the onshoring of manufacturing and their impact on total medical costs, most notably on pharmaceuticals, a total price impact of 3.6% is built into the initially submitted rate filing.'"
Given all this, longtime supporters of Medicare for All encouraged their fellow Americans to consider a different way of handling healthcare.
"Next year, Americans will see the biggest jump in health insurance costs in 15 years," commented former US Labor Secretary Robert Reich. "Meanwhile, the six largest health insurers raked in more than $31 billion in net income last year. Still not sure if we need Medicare for All?"
Warren Gunnels, a staffer for US Sen. Bernie Sanders (I-Vt.), cited studies by the Congressional Budget Office and Yale to argue that Medicare for All would be a net money saved.
"Your daily reminder: Medicare for All would save $650 billion and 68,000 lives each and every year while providing comprehensive healthcare to every man, woman, and child with no premiums, no deductibles, and no co-payments," he wrote.
Melanie D'Arrigo, the executive director of Campaign for New York Health, argued that the best part of Medicare for All is that it would simply make the private insurance industry obsolte.
"Your periodic reminder that health insurance is not healthcare," she said. "It's an unnecessary middleman designed to restrict access to healthcare and exploit people for profit. The fiscal and moral path forward is universal healthcare with Medicare for All."
Rep. Ro Khanna (D-Calif.) reacted to the news of insurance price hikes with a simple message.
"Medicare for All. Now," he wrote.
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