Nearly 450 hospitals across the United States face a high risk of closing or cutting services due to more than $900 billion in cuts to Medicaid and the Children’s Health Insurance Program (CHIP) under President Donald Trump‘s One Big Beautiful Bill Act, according to a report released Tuesday by watchdog group Public Citizen.

Medicaid currently covers about a fifth of all hospital spending.

The at-risk hospitals collectively served nearly seven million patients in 2024, with roughly 275,000 direct patient care workers and nearly 70,000 beds, according to the report.

“Trump’s cuts to Medicaid will hurt millions of low-income and disabled Americans, and will deepen financial strains already plaguing rural and safety-net hospitals,” said Eileen O’Grady, researcher and report author at Public Citizen.

Who Gets Hit Hardest

Rural hospitals and those serving Black and Latino patients face disproportionate risk. More than a quarter of all hospitals are at risk in Connecticut, California, New York, Massachusetts, and Washington.

About 60% of at-risk hospitals are in urban areas, though rural facilities remain especially vulnerable. The Trump administration's Rural Health Transformation Program sets aside $50 billion to help modernize care, including pilot projects using AI-driven tools, digital avatars, and robotic diagnostics, but the fund covers only about a third of projected Medicaid losses in rural areas, and many hospitals may not receive any relief.

Industry Already Feeling The Strain

Hospitals have already begun laying off staff and scaling back maternity and mental health services. Trinity Health projects losses of $1.5 billion due to policy changes. Alameda Health System in Oakland announced nearly 300 layoffs and projected losses exceeding $100 million annually by 2030.

Bank of America (BofA) Securities estimates hospitals will face a 2–4% EBITDA headwind annually for five years, with Universal Health Services Inc. (NYSE:UHS) and Ardent Health Inc. (NYSE:ARDT) expected to be hit hardest.

Disclaimer: This content was produced with the help of AI tools and was reviewed and published by Benzinga editors.

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