Increase funding for rural hospitals to prevent closures

I pulled every rural hospital closure and conversion from the Sheps Center database going back to 2010. 152 total across 33 states. The Southeast corridor stands out but it's not only a Southern problem. Maine, Minnesota, California, Pennsylvania all show up. The common thread is the reimbursement math. Medicare pays 83 cents per dollar of actual cost (AHA 2026 data). Medicaid pays about 88 cents. Rural hospitals are disproportionately dependent on both because their populations skew older and lower income. The commercial insurance base that cross-subsidizes those losses in urban hospitals barely exists in most rural counties. 41% of rural hospitals are currently operating at a loss. 417 are flagged as vulnerable to closure by Chartis. After a rural hospital closes, inpatient mortality in the surrounding community increases 8.7% (NBER) and average ambulance transport time jumps from 14.2 to 25.1 minutes. CHQPR estimates it would cost roughly $6 billion per year to prevent all at-risk closures. That's about one tenth of one percent of total national healthcare spending. Sources: UNC Cecil G. Sheps Center (closure database, accessed March 2026). Chartis Center for Rural Health 2025/2026 reports. AHA Costs of Caring 2026. NBER Working Paper 26182. University of Kentucky Rural Health Research Center. CHQPR 2025 analysis.