Healthcare Crisis in Rural America Due to New Legislation

The passage of significant legislation by Congress in 2025 has intensified challenges faced by rural health care systems across the United States, including in Wisconsin. This law, identified by the Center for American Progress, reduces federal support for the Affordable Care Act (ACA), Medicaid, and medical and nursing student loans. Consequently, concerns are rising over the shortage of health professionals in rural areas.

The Congressional Budget Office anticipated that these cuts could eventually lead to 17 million individuals losing their health insurance coverage, impacting 276,000 people in Wisconsin. The failure to maintain ACA's enhanced premium tax credits further contributes to this decline, with a documented drop in ACA enrollment exceeding a million nationally and over 22,000 in Wisconsin. Future legislative amendments, including restricted enrollment periods and stringent eligibility criteria, could reduce Medicaid and ACA participation.

This scenario presents a critical financial threat to rural hospitals. A significant percentage of rural residents, including farmers and ranchers, rely on ACA or Medicaid for their health insurance. According to the Center for Health Care Quality and Payment Reform (CHQPR), over 700 rural hospitals might face closure due to severe financial difficulties, including 12 hospitals in Wisconsin, with five at immediate risk. The Wisconsin Medical Society reiterates that these coverage reductions will exacerbate the crisis in rural health care by precipitating hospital and nursing home closures, thereby restricting access to health services.

The CHQPR has highlighted that hospital closures predominantly impact isolated rural communities, necessitating residents to travel long distances for emergency or inpatient services. This situation poses a risk to the nation’s food supply and energy production, as it affects the viability of rural areas essential for farming and energy facilities.

In response, Wisconsin Democratic Senator Tammy Baldwin and Democratic candidate Rebecca Cooke have proposed solutions, including increasing Medicare and Medicaid reimbursement rates to sustain rural hospitals and reversing the health coverage cuts enacted by the legislation. Baldwin emphasized the need for improved healthcare provisions for Wisconsinites, while Cooke stressed the precarious situation of rural hospitals and called for decisive leadership to address ongoing healthcare challenges.