Jennifer Balkcom: The One Big Beautiful Bill Threatened The Closure Of Vital Rural Hospitals, Including MH Angel Medical Center And Blue Ridge Regional Hospital In NC-11

North Carolina Rural Hospitals Could Lose $3.7 Billion In Medicaid Payments Due To The One Big Beautiful Bill

August 2025: Asheville Citizen Times: North Carolina Rural Hospitals Could Lose $3.7 Billion In Medicaid Payments Due To The One Big Beautiful Bill. “Rural hospitals were already struggling financially when Trump signed his signature tax bill into law July 4. Nearly 200 across the country — including 12 in North Carolina — have closed in the last 20 years, according to UNC-Chapel Hill’s Sheps Center for Health Service Research, which tracks closings. With Trump’s ‘One Big Beautiful Bill,’ researchers estimate another 300 are at risk of shuttering. […] A little more than a week later, in a briefing with state lawmakers, officials said the state’s rural hospitals could lose $3.7 billion in Medicaid payments. Only up to half that amount could be offset by a five-year, $50 billion rural hospital fund Senate Republicans set up as a safety net to mitigate the bill's impact, according to the agency. One Republican lawmaker, Sen. Josh Hawley of Missouri, has already filed legislation to double it.” [Asheville Citizen Times, 8/8/25]

The One Big Beautiful Bill Would Result In $50.4 Billion Reduction In Spending For Rural Hospitals Over The Next Ten Years. “Medicaid, which covers over 16 million people in rural communities, helps address barriers to health care and sustain rural hospitals. But many in Congress are considering Medicaid cuts that would have a devastating impact on rural hospitals and patients. The One Big Beautiful Bill Act (H.R. 1) would result in 1.8 million individuals in rural communities losing their Medicaid coverage by 2034. In addition, select Medicaid provisions in H.R. 1 would result in a $50.4 billion reduction in federal Medicaid spending on rural hospitals over 10 years.” [American Hospital Association, 6/16/25]

The Cuts To Medicaid And Other Federal Health Programs In President Trump’s Budget Plan Would “Rapidly Push” More Than 300 Financially Struggling Rural Hospitals Toward A Fiscal Cliff. “Cuts to Medicaid and other federal health programs proposed in President Donald Trump’s budget plan would rapidly push more than 300 financially struggling rural hospitals toward a fiscal cliff, according to researchers who track the facilities’ finances. The hospitals would be at a disproportionate risk of closure, service reductions, or ending inpatient care, according to a report authored by experts from the Cecil G. Sheps Center for Health Services Research following a request from Senate Democrats, who released the findings publicly Thursday. Many of those hospitals are in Kentucky, Louisiana, California, and Oklahoma, according to the analysis.” [KFF, 6/12/25]

Two Rural Hospitals In NC-11 Were At Risk Of Closing Due To The One Big Beautiful Bill

2025: NC-11 Had Two Rural Hospitals Listed As At-Risk Of Closing Due To The One Big Beautiful Bill Based On Financial Vulnerability. “In order to understand in greater detail how rural communities could be impacted by health care cuts contained in the reconciliation package, we requested the attached data from the Sheps Center on the financial vulnerability of rural hospitals and potential impacts on their viability. These hospitals have been identified as at-risk hospitals based on financial data, including: whether the hospital has been unprofitable for the last three years; whether the hospital is at risk of financial distress relative to peer hospitals; and whether the hospital serves a disproportionately high share of Medicaid patients. The findings demonstrate that hundreds of rural hospitals across the country would feel pain from the House-passed reconciliation bill.” [Office of Senator Edward J. Markey, Letter on Rural Hospitals, 6/12/25]

[Office of Senator Edward J. Markey, At-Risk Rural Hospitals List, 6/12/25]

Cuts To Health Care Funding In The OBBB Could Drive Up Costs Of Care And Threaten North Carolina’s Rural Hospitals After “Helene Overwhelmed Hospitals And Healthcare Providers” In The Region. “Helene overwhelmed hospitals and healthcare providers in our region, where residents are older, poorer, and sicker than in many other parts of America. People without health insurance often skip seeing a doctor for preventative services and use hospital emergency rooms for their primary healthcare. Our hospitals in western North Carolina are already struggling with staffing and low government reimbursement rates. The left-leaning Center for American Progress projects that the Medicaid cuts, along with the House refusing to extend the enhanced premium tax credits of the Affordable Care Act, could drive up uncompensated care costs in North Carolina by $1.48 billion by 2034, threatening the financial viability of the state’s rural hospitals, 12 percent of which are already at immediate risk of closure.” [Asheville Watchdog, Peter H. Lewis Op-Ed, 7/21/25]

Mitchell County Residents Expressed Concerns That The One Big Beautiful Bill Would Shut Down Blue Ridge Regional Hospital

Asheville Citizen Times Headline: “In Mitchell County, Residents Fear The ‘Big Beautiful Bill’ Will Shut Down Their Hospital.” [Asheville Citizen Times, 8/8/25]

Daniel Barron, A Retired Professor Living In Rural Mitchell County, And Other Mitchell County Residents, Expressed Concern That Blue Ridge Regional Hospital In Spruce Will Financially Suffer, Due To The One Big Beautiful Bill. “When Daniel Barron had a double hernia repaired in late June, the 80-year-old retired professor only had to drive about 20 minutes from his home near Bakersville, in rural Mitchell County, to Blue Ridge Regional Hospital in Spruce Pine. […] But Barron and other Mitchell County residents fear for the future of their hospital, now that President Donald Trump signed his sweeping domestic policy legislation into law in July. With cuts to Medicaid expected to total $1 trillion across the U.S. and nearly $50 billion in North Carolina over 10 years, critics and health advocates warn that Trump's ‘One Big Beautiful Bill’ will lead to the loss of health coverage for some of the nation’s most vulnerable people. They also worry the rural hospitals that care for them, like Blue Ridge Regional in Spruce Pine — which provided critical life-saving care in the wake of Tropical Storm Helene — will financially suffer, forcing hospitals to shutter and devastating the communities they serve even further.” [Asheville Citizen Times, 8/8/25]

• Blue Ridge Regional Hospital Was A “Critical Access Hospital Care In Spruce Pine And The

Surrounding North Carolina Mountain Communities Of Mitchell County.” “Critical access hospital care in Spruce Pine and the surrounding North Carolina mountain communities of Mitchell County: Blue Ridge Regional Hospital features 25 patient beds and a variety of medical services for both children and adults. Some of these services include cardiology, emergency care, imaging, infusion services, obstetrics and gynecology, oncology, orthopedics, pregnancy care, rehabilitation, surgery, wound treatment and women's care.” [Blue Ridge Regional Hospital, accessed 8/14/26]