Rural Hospitals on the Brink: Medicaid Cuts & the so-called “Big, Beautiful Bill”

Rural America is in the middle of a healthcare crisis — and the so-called “Big, Beautiful Bill” could make it worse. In this episode, Bill Bernadoni is joined by Michael Topchik, Executive Director of the Chartis Center for Rural Health, to break down how proposed Medicaid cuts could devastate rural hospitals already fighting to keep their doors open. With nearly half of rural hospitals losing money and over 450 at risk of closure, these cuts would hit the most vulnerable communities hardest. Topchik explains why the free market can’t save rural healthcare, how bipartisan carve-outs are offering only temporary relief, and why some states may be hit harder depending on their Medicaid expansion status. From high fixed costs to dwindling margins, this is the fight for survival in rural healthcare. What happens when the safety net frays — and is there any path forward before it snaps?