Hospitals and clinics across the United States have begun shutting down or reducing services following the passage of the One Big Beautiful Bill Act, the tax-and-spending legislation signed by President Donald Trump. The law is expected to cut federal funding by hundreds of billions of dollars, leading to an estimated 10 million people losing health insurance, with low-income Americans disproportionately affected.
Rural hospitals and obstetric wards are particularly vulnerable. Researchers from the University of North Carolina at Chapel Hill found that more than 300 rural hospitals are at risk of closure or cutting services. Almost 100 are located in counties with no other source of obstetric care, according to the National Partnership for Women and Families. White, Native American and low-income women are especially likely to lose their sole source of care.
In Georgia, St Mary's Sacred Heart hospital in Lavonia closed its obstetric ward in October, citing the Medicaid cuts as a contributing factor. Patients must now travel nearly an hour for care. Tammy Frye, who runs a local pregnancy care centre, reported that expectant mothers were left scared and confused, with many lacking reliable transport.
In Kansas, Freeman Health System abandoned plans to open a new hospital in a rural area due to the unpredictable impact of the legislation. Meanwhile, Maine Family Planning, which operates 18 clinics, was forced to stop offering primary care in October after a provision in the bill blocked Medicaid reimbursements for abortion providers. About 70% of its patients relied solely on the organisation for healthcare.
Heather Curran, a primary care nurse practitioner in Aroostook County, lost her job after a decade with Maine Family Planning. She expects many former patients will face long waits or go without care. Michael Shepherd, an assistant professor at the University of Michigan, noted that while the law is not the sole cause of closures, it can be the 'death knell' for financially struggling hospitals.
