LOCALIZE IT: Trump’s multitrillion-dollar tax and spending cut bill hits Medicaid, rural hospitals
Associated Press
EDITORS/NEWS DIRECTORS:
House Republicans in Congress approved President Donald Trump’s multitrillion-dollar tax breaks and spending cuts bill in a narrow vote Thursday, overcoming setbacks to pass Trump’s signature second-term policy package before a Fourth of July deadline. To help offset the lost tax revenue, the package includes $1.2 trillion in cuts over 10 years to Medicaid and other social safety net programs.
But states and rural health advocacy groups warn that cutting Medicaid — a program serving millions of low-income and disabled Americans — would hit already fragile rural hospitals hard and could force hundreds to close, stranding some people in remote areas without nearby emergency care and other health services.
More than 300 hospitals could be at risk for closure under the Republican bill, according to an analysis by the Cecil G. Sheps Center at the University of North Carolina at Chapel Hill, which tracks rural hospital closures. Even as Congress haggled over the controversial bill, a health clinic in the southwest Nebraska town of Curtis announced Wednesday it will close in the coming months, in part blaming the anticipated Medicaid cuts. And while the bill includes a provision that will provide $10 billion annually to buttress rural hospitals over the next five years, many rural hospital advocates are wary that it won’t be enough to cover the shortfall.
Here’s data and resources you can use to localize the projected impact of this bill on your state’s Medicaid funding and rural hospitals.
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READ AP’S STORY
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FIND YOUR STATE: ESTIMATED MEDICAID CUTS
How will the bill affect Medicaid funding in your state? You can use this interactive map to see estimates for how much federal Medicaid funding states will lose under the bill. The estimates are from a KFF analysis of figures from the Congressional Budget Office. KFF estimates in its analysis that some states could lose one-fifth of their federal Medicaid spending.
An embed code for the same interactive map can be found at the end of this guide.
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OTHER RESOURCES
Use this KFF fact sheet to see figures for the percentage of people covered by Medicaid in each state. And a separate KFF report shows 36 states losing $1 billion or more over 10 years in Medicaid funding for rural areas under the Republican bill.
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CONSIDER THESE QUESTIONS
— How much federal Medicaid funding is my state projected to lose under the bill?
— Are any rural hospitals in my state impacted by the Medicaid cuts? The Center for Healthcare Quality and Payment Reform keeps data on rural hospitals that can be a good starting point for sourcing.
— Are any rural hospitals planning on closing entirely due to the anticipated Medicaid cuts? If such closures happen, what would be the next closest hospital for people in that community? Are there any specific departments in rural hospitals at risk for closure that would have an impact — like labor and delivery units? mental health care beds?
— How many people in my state rely on Medicaid for healthcare and how will they be impacted by the bill? (The KFF fact sheet linked above is one resource for this.)
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EMBED THIS GRAPHIC
This AP digital embed map shows estimated cuts to federal Medicaid spending by state over the next decade, according to a KFF analysis of figures from the Congressional Budget Office based on the Senate version of President Donald Trump’s tax and spending cuts package. This map is current as of July 2, 2025 and will not update. Source: KFF.
To embed, insert this code into your CMS:
!– start AP embed —
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!– end AP embed —
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SOME PREVIOUS AP COVERAGE OF THE LEGISLATION AND ITS IMPACT
Medicaid, food aid recipients worry about safety net cuts in bill sent to Trump
The House gives final approval to Trump’s big tax bill in a milestone for his second-term agenda
What’s in Trump’s big bill that passed Congress and will soon become law
Here’s how millions of people could lose health insurance if Trump’s tax bill becomes law
Americans want Medicaid and food stamps funding maintained or increased, AP-NORC poll shows
A look at how Trump’s big bill could change the US immigration system
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Localize It is a reporting resource produced by The Associated Press for its customers’ use. Questions can be directed to the Local News Success team at localizeit@ap.org.
