A rural Nebraska clinic blames its closing on Trump’s Medicaid cuts. Patients don’t buy it. "Horse Feathers"

Servus said:

Did any rural clinics or hospitals close from 2020 to 2024?

Yes, there was a significant trend of rural hospital and clinic closures between 2020 and 2024.

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Sure, and Trump's response was to cut further billions from their budgets.

And North Carolina

Rural health care in focus: NC lawmakers raise concerns over shortage of nurses, doctors​

There aren’t enough nurses and doctors in North Carolina, state leaders say, a problem that’s particularly acute in rural areas. Meanwhile, cuts to Medicaid and other economic factors threaten rural hospital closures.

North Carolina received $213 million from that [$50B federal] project to help bolster rural health access and care. Sangvai said DHHS will oversee the work, but that it will be largely decentralized with local leaders having wide latitude to decide what they need. Some areas may need more attention on mental health care, while others may need more OBGYNs or primary care doctors.

The [federal] cuts are expected to drain billions of dollars out of North Carolina’s health care economy, according to hospital industry leaders. The $213 million from the new project would cover a small portion of those expected losses.

Other than U.S. Sen. Thom Tillis, who opposed Trump's plan, all of North Carolina's Republican members of Congress backed it, saying the Medicaid cuts were needed to pay for new tax cuts.

They counted on a rural dialysis unit to keep them alive. Then it closed​

HAY SPRINGS, Neb. — The sun was just warming the horizon as Mark Pieper left his house near his cattle ranch on a crisp February morning.

It's not unusual for the rancher to wake up early to tend to livestock, but at 5:45 a.m. this day his cattle wouldn't come first. For the past 3½ years, three days a week, Pieper has made an early-morning commute to get dialysis at the nearest hospital.

That February morning was one of his last dialysis sessions there before the hospital shuttered the service at the end of March.

[CEO] Reiners said Chadron Hospital lost $1 million a year on its dialysis service due to low reimbursement rates that didn't cover operational costs.

"I guess I'll just bloat up and die in a month," Pieper remembered thinking when he learned the center was closing, eliminating the only option near his home.

He needs dialysis to survive after cancer treatment damaged his kidneys.

Others are making long drives to other dialysis centers. Pieper eventually found treatment in Scottsbluff, which, with about 14,000 residents, is the biggest city in the rural Panhandle region of western Nebraska. The 1 1/2-hour drive will triple his time on the road to more than nine hours each week.

[Wife of a different patient] Simonson said she spoke with aides for the governor and her state representatives but none of the leaders called her back.

"It feels like they don't know that we exist at this end of the state," she said.

Rural Minnesota

Months after Mayo Clinic left, some rural towns adjust to a ‘completely different health continuum’​

Mayo Clinic Health System closed six outpatient clinics in late 2025. The move left two communities, Caledonia and Montgomery, without a primary care provider​

As of November 2025, primary care is an unfilled niche in Caledonia, a community of 2,800 in the heart of Houston County. That month, the local Mayo Clinic Health System closed its outpatient clinic there, transitioning those staff members to the La Crosse, Wis., location.

In September, Mayo Clinic Health System announced the closure of Caledonia’s clinic and five others in rural communities: Belle Plaine, Montgomery, St. Peter, North Mankato and Wells. The changes also included some service reductions at Mayo Clinic Health System’s hospital campus in Albert Lea.

"I don’t understand why they did it,” said Jake Dickson, Caledonia’s city clerk and administrator. “It was just labeled as consolidation, and there has to be some sort of reason for it, but up here we don’t understand what that reason could be.”

Rural Southeast Minnesota is not an isolated case. With impending federal changes to Medicaid, workforce issues and the increasing cost of American healthcare, many rural healthcare providers are in “a period of uncertainty to outright stress,” said Michael Shepherd, an assistant professor of health management and policy at the University of Michigan School of Public Health.

The bigger picture​

While the national decline in rural hospital access is well-documented by researchers and industry leaders, tracking rural outpatient and primary care availability is more difficult. This is because patients get their primary care from various sources: clinics, hospitals, mobile clinics, telehealth appointments through health systems or corporate services such as Amazon One Medical.

But those hospital closures, in particular, can have a ripple effect on a community’s access to primary care, said Carrie Henning-Smith, an associate professor at the University of Minnesota School of Public Health and co-director of the university’s Rural Health Research Center.

“When hospitals close, that doesn’t just mean losing those inpatient services,” Henning-Smith said. “It also means losing outpatient services and sometimes means losing satellite clinics that were affiliated with the hospital.”

Ahead of midterms, Republicans run ads after cutting healthcare funds​

Republicans campaigning in swing districts are running ads about healthcare after facing criticism of the cuts in the One Big Beautiful Bill Act. Many of these ads target voters over 35 years old and focus on three topics: Medicaid fraud, rural hospitals and affordability.

In response to criticism over cuts to rural hospitals, Congress included the Rural Healthcare Transformation Act (RHTA), co-sponsored by Lawler, in the One Big Beautiful Bill Act. The $50 billion in funding from the RHTA doesn't offset the $137 billion in Medicaid cuts that would directly affect rural areas, though, according to an analysis by KFF.

There's also an expected gap in implementation, with the threat of "clawbacks," where money is taken back if states don't meet outcomes.

Key changes [in the BBB], like the reduction of Medicaid funding, don't occur until after this year's midterms, so candidates see this as an opportunity to emphasize other, popular parts of the law, like tax cuts.

Republican lawmakers are laying the groundwork for blame if the opposing party gains power in the future, according to political scientist Daniel Hopkins.

"Some of the key changes, for instance, [like] the reductions in Medicaid funding, are scheduled to kick in years down the road," he said. "That time disconnect makes it really hard for voters to tangibly feel and react to changes that are in the future."