Law Center Report: GOP Bill Will
Worsen Hospital Closure Trend
MONTGOMERY, Ala. — (SPLC) -- 5/12/2026 -- The Southern Poverty Law Center (SPLC) recently released Critical Condition: Rural Health Care Access Following HR 1, a report that examines how implementation of the so-called “Big Beautiful Bill” could exacerbate a dangerous trend of hospital closures throughout the rural South.
Between 2005 and 2023, at least 146 rural hospitals across the country stopped offering inpatient services, with 34 located in the Deep South. New analysis from the SPLC shows that an additional 99 rural hospitals in Alabama, Florida, Georgia, Louisiana and Mississippi could also be at risk of closing.
“For people living in the rural South, hospital closures aren’t just an inconvenience; they can be the difference between whether a person survives a trip in an ambulance or doesn’t make it in time to receive lifesaving care,” said Gina Azito Thompson, policy analyst, SPLC. “Unfortunately, these critical lifelines are under threat thanks to devastating cuts to programs that ensure Americans in these areas have health insurance. In a region with alarming rates of chronic illness, diabetes and high blood pressure, making healthcare more expensive will result in people forgoing necessary visits to the doctor, causing treatable problems to turn deadly.”
The current U.S. healthcare system relies heavily on patients’ insurance to ensure that doctors and hospitals get paid for providing care. As the report notes, many rural hospitals are already operating on slim profit margins, with residents in their areas less likely to be able to afford their medical expenses.
The legislation passed by Congress in 2025 cut more than $1 trillion of federal funding from healthcare programs including Medicaid, which the Congressional Budget Office forecasts could result in millions of low-income Americans losing health insurance. This could in turn cut off critical revenue streams for rural hospitals.
“When we talk about making America healthy, one of the fundamental ways to do that is to ensure everyone can see a doctor or health professional without the fear of taking on tremendous medical debt,” added Azito Thompson. “By kicking people off of their insurance, this administration’s signature piece of legislation will only worsen so many of the health disparities that already exist across the Deep South.”
In addition to exploring how rural Southerners’ insurance could be impacted by HR 1, the report also outlines recommendations for policymakers to help strengthen rural healthcare infrastructure and prevent unnecessary hospital closures.
Between 2005 and 2023, at least 146 rural hospitals across the country stopped offering inpatient services, with 34 located in the Deep South. New analysis from the SPLC shows that an additional 99 rural hospitals in Alabama, Florida, Georgia, Louisiana and Mississippi could also be at risk of closing.
“For people living in the rural South, hospital closures aren’t just an inconvenience; they can be the difference between whether a person survives a trip in an ambulance or doesn’t make it in time to receive lifesaving care,” said Gina Azito Thompson, policy analyst, SPLC. “Unfortunately, these critical lifelines are under threat thanks to devastating cuts to programs that ensure Americans in these areas have health insurance. In a region with alarming rates of chronic illness, diabetes and high blood pressure, making healthcare more expensive will result in people forgoing necessary visits to the doctor, causing treatable problems to turn deadly.”
The current U.S. healthcare system relies heavily on patients’ insurance to ensure that doctors and hospitals get paid for providing care. As the report notes, many rural hospitals are already operating on slim profit margins, with residents in their areas less likely to be able to afford their medical expenses.
The legislation passed by Congress in 2025 cut more than $1 trillion of federal funding from healthcare programs including Medicaid, which the Congressional Budget Office forecasts could result in millions of low-income Americans losing health insurance. This could in turn cut off critical revenue streams for rural hospitals.
“When we talk about making America healthy, one of the fundamental ways to do that is to ensure everyone can see a doctor or health professional without the fear of taking on tremendous medical debt,” added Azito Thompson. “By kicking people off of their insurance, this administration’s signature piece of legislation will only worsen so many of the health disparities that already exist across the Deep South.”
In addition to exploring how rural Southerners’ insurance could be impacted by HR 1, the report also outlines recommendations for policymakers to help strengthen rural healthcare infrastructure and prevent unnecessary hospital closures.
