Rural hospitals brace for changes after One Big Beautiful Bill passes

SALT LAKE CITY (ABC4) — Throughout Utah, 21 rural hospitals are now bracing for unknown changes after the One Big, Beautiful bill passed earlier this month. 

Rural healthcare providers said it will negatively affect residents in rural areas and rural hospitals. 

“We anticipate especially with nursing, it’s going to change nurse-to-patient ratios, which is going to have a dramatic impact on healthcare because nursing is such a big impact on healthcare,” Kasey Shakespear, Executive Director of the Rural Health Association of Utah, said. 

The bill includes cuts to Medicaid, Medicare, SNAP, and other rural health care programs. 

“There won’t be any hospital closures in the next few months, but we have to start preparing and looking at ways we can cut costs,” Matt McCullough, Rural Hospital Improvement Director for the Utah Rural Hospital Association, said. 

A recent report from the National Rural Health Association stated that rural hospitals will lose 21% of their Medicaid funding, which they estimate to be nearly $70 billion over ten years. 

“It’s going to be a bumpy ride, but we’re in Utah, and overcoming adversity is what we do,” Shakespear said. 

Despite the challenges, McCullough said the Rural Hospital Association has a plan. 

“Utah Hospital Association is working with the state and will start having those discussions to figure out what’s going to happen to the Medicaid program in the state, how the program is going to be funded, eligibility, and whether we will still be an expansion state or not,” McCullough said. 

One part of the bill is the Rural Health Transformation fund, a $50 billion federal investment over five years to help with Medicaid cuts. 

“The state is working with the federal government on what that is going to look like,” Shakespear said. 

Healthcare providers said nearly half of that $25 billion will be evenly distributed to all 50 states, with each state getting around $100 million over the next five years. 

“The rural transformation funding was created to help with that, but it is covering less than half of what was cut,” Shakespeare said. 

To access those funds, each state must submit a plan to the federal government by the end of the year on how the funds will be used and which services it will support.  

“This is going to be challenging, but it’s a call to action in how we revise healthcare, especially in the rural communities,” Shakespeare said. 

Rural healthcare providers said there is still a lot up in the air, but they are working to respond to these major Medicaid and funding cuts and are expecting to have more clarity in the upcoming months.