Letter Text (PDF)

Washington (June 4, 2025) – Senator Edward J. Markey (D-Mass.), a member of the Health, Education, Labor, and Pensions (HELP) Committee, Democratic Leader Chuck Schumer (D-N.Y), Senator Ron Wyden (D-Ore.), Ranking Member of the Finance Committee, and Senator Jeff Merkley (D-Ore.), Ranking Member of the Budget Committee, today wrote to Mark Holmes, PhD, Director of the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill, requesting analysis of the impact of House Republicans’ budget bill’s proposed cuts to federal spending on health programs, on rural hospitals, and their surrounding communities. 

In the letter the lawmakers write, “The independent, nonpartisan Congressional Budget Office estimates this bill and other regulatory actions by the Trump administration will lead to nearly 14 million Americans losing their health insurance and shifting billions of dollars in health care costs to states. In short, the House-passed budget reconciliation bill is expected to have substantial and devastating impacts to health care access for working families across America, particularly in rural communities. We are deeply concerned that these cuts will increase uncompensated care and make it more difficult for rural hospitals to continue providing services to all patients, paying workers, and keeping their doors open.”

The lawmakers continue, “The magnitude of federal cuts to health programs will inevitably devastate health access for millions of Americans who will see their local hospitals forced to reduce services or close altogether. To help us better understand the devastation of these cuts, we are interested in the Sheps Center’s expert analysis of how this bill will impact rural hospitals and the communities they serve.”

The lawmakers request responses to the following questions by June 11, 2025:

  1. Which U.S. rural hospitals treat the highest share of Medicaid recipients? Please identify these hospitals by name, state, and congressional district.
  1. How many rural hospitals are currently in financial distress or at risk of closure? Please identify these hospitals by state and congressional district and whether these hospitals are eligible for any Medicare rural hospital designation.
  1. If the health care cuts in the House-passed budget reconciliation bill were to become law, would the rural hospitals with the highest share of Medicaid recipients or that are currently in financial distress face risk of closure or having to reduce services (including obstetric and behavioral health care, emergency room services, etc.)

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