Democrats Spread Falsehoods on Rural Hospital Closures While Republicans Actually Do Something About It

As Democrats Attempt to Use the Long-Running Issue of Rural Hospital Closures to Distract From Their Disastrous Medicaid Policies, Republicans Created a $50 Billion Rural Hospital Fund to Address Shortfalls

AMERICA’S RURAL HOSPITALS HAVE STRUGGLED TO STAY OPEN FOR SEVERAL DECADES, EVEN AS MEDICAID SPENDING HAS SKYROCKETED

Since 2005, 196 rural hospitals have either closed or converted. 153 of these occurred since 2010. (University of North Carolina: Rural Hospital Closures – accessed 7/17/25)

- Hospital conversions are the elimination of inpatient services while maintaining other care such as emergency, primary, outpatient, or urgent care. (U.S. Department of Agriculture: Federal Assistance and Rural Hospital Closings: The Impact of the USDA Community Facilities Program – Jan. 2025)

“Medicaid expansion has failed to halt rural hospital closures, and in some cases it contributes to them. The reason is simple: Medicaid is so poorly run that it often adds financial burdens to hospitals.” (The Wall Street Journal: op-ed: Medicaid Expansion Won’t Stop Rural Hospital Closures – 4/28/23)

“Since 2014, dozens of hospitals have closed in states that haven’t expanded Medicaid. Yet their stated reasons almost always have nothing to do with Medicaid expansion.” (The Wall Street Journal: op-ed: Medicaid Expansion Won’t Stop Rural Hospital Closures – 4/28/23)

“Even more telling is what happened in the nearly 40 states that did expand Medicaid before the start of this year. Despite the assurances of liberal activists, nearly 50 hospitals have closed in these states since expansion passed, including more than a dozen in rural areas.” (The Wall Street Journal: op-ed: Medicaid Expansion Won’t Stop Rural Hospital Closures – 4/28/23)

REPUBLICANS’ RECONCILIATION LAW CREATED A $50 BILLION RURAL HEALTH TRANSFORMATION BRIDGE FUND

“It provides $50 billion to rural hospitals over the next five years… This important legislation supports Nebraskans and Americans living in rural areas by supporting their hospitals and health care facilities.” –Sen. Pete Ricketts (R-Neb.)

The law invests $50 billion in a rural health transformation program to improve access to care and stabilize critical hospitals and other providers. (Politico: GOP boosts rural hospital fund – 7/1/25)

“A targeted rural hospital fund is the most efficient and sensible way to assist facilities at risk of closure without perpetuating broad-based abuse. Enacting these changes is essential to preserve Medicaid’s mission and ensure a sustainable, accountable safety net.” (Paragon Health Institute: Championing Senate Reforms and Countering Rural Hospital Hysteria in the Fight Against Medicaid Money Laundering – 6/27/25)

“[W]e do think that 50 billion dollars is ultimately a lifeline for those hospitals that are struggling.” –Nebraska Hospital Association President Jeremy Nordquist
This significant investment will not only support providers through any transition period but will also make resources available for investments in technology and workforce that will bolster long-term financial viability to ensure Americans get access to the care they need. (Bipartisan Policy Center: Rural Hospitals and the Rural Health Transformation Program: What Comes Next – 7/10/25)

Less than 5% of overall Medicaid inpatient hospital spending actually goes to rural hospitals: “According to the Centers for Medicare and Medicaid Services (CMS) Office of the Actuary, just 4.9% of overall Medicaid inpatient hospital spending goes to rural hospitals. This illustrates how financing abuses such as provider taxes and SDPs have not been targeted to the most vulnerable.” (White House: Memorandum to Senate Republicans – accessed 7/17/25)

DEMOCRATS ARE SPREADING FALSEHOODS ABOUT REPUBLICANS’ RECONCILIATION LAW IN ORDER TO DISTRACT FROM THE MEDICAID MESS THEY CREATED

“[T]he legislation strengthens Medicaid by eliminating waste, fraud, and abuse in a program that saw more than $1 trillion in improper payments over the past decade.” – Sen. Marsha Blackburn (R-Tenn.)

In five years since FY2019, federal Medicaid spending exploded by 54%. (Congressional Budget Office: The Federal Budget in 2019: An Infographic – 4/15/20; Congressional Budget Office: Discretionary Spending in Fiscal Year 2024: An Infographic – 3/20/25)

The federal Medicaid program spent $1.1 trillion on improper payments from 2015 to 2024, according to the Paragon Health Institute and the Economic Policy Innovation Center. (Paragon Health Institute: $1.1 Trillion of Federal Medicaid Improper Payments Over Last Decade – 3/5/25)

“Over the last decade, Medicaid has outpaced the growth of the other two largest federal entitlement programs: Social Security and Medicare.” (Cato Institute: Medicaid Is Driving Deficits: Republicans Are Scarcely Tapping the Brakes – 5/13/25)

Democrats expanded access to Medicaid beyond those who the program was intended to cover:
- “The Biden administration has enacted several major Medicaid rule changes with giant fiscal costs,” including a rule finalized in 2024 that keeps people on Medicaid “when they are no longer eligible,” while restricting the times “when states may verify changes in eligibility.” (Paragon Health Institute: Biden’s Medicaid Changes: High Costs, Misguided Policy – 11/6/24)

- Democrat-run states expanded their state Medicaid programs to illegal immigrants and several have been forced “to roll back or freeze the programs because of budget woes…” (The Wall Street Journal: Democratic States Expanded Healthcare to Undocumented Immigrants. Now They’re Rolling It Back. – 6/19/25)

- “You won’t find many voters who think the federal government should focus scarce health resources on working-age men over poor children and pregnant women. Yet that is what the perverse financing formula encourages, as states can grab more federal dollars if they sign up more prime-age adults.” (The Wall Street Journal: Editorial: The GOP’s Medicaid Moment of Truth – 5/4/25)

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