Trump’s BBB could close 1 in 7 Georgia hospitals and cost $540M
Georgia ranks among the most expensive states in the U.S. for healthcare, and now rural hospitals face major challenges due to changes from the One Big Beautiful Bill Act.
The changes to Medicaid included in the BBB could force some rural hospitals to close, costing close to $540 million, says the American Hospital Association, and would result in 1.8 million individuals losing their coverage by 2034.
Why are rural hospitals struggling?
The biggest issue is deep cuts to Medicaid funding. The Georgia Health Initiative reports that, as of mid-2025, approximately 2.3 million residents are enrolled in Medicaid, including children.
Of those 2.3 million, Commonwealth Fund reports approximately 48% of those enrollees live in rural areas and are serviced by one of the 71 rural hospitals in the state.
The National Rural Health association identifies a few key problems the hospitals will face:
Loss of Medicaid dollars: Medicaid payments are being rreduced, which can make it difficult to pay staff, buy supplies or keep all services open.
Low reimbursement rates: For some services, Medicaid covers only about 63% of costs for specialized care, so either hospitals will eat the remaining amount or it will be passed on to patients.
Shrinking local populations: As younger populations move away, older and less healthy populations remain, needing more care.
Fewer backup options: Larger, better equipped hospitals may be miles away, leaving many without emergency care.
What services will be cut?
The AHA says administrators at some of the hospitals are being forced to consider difficult decisions, including:
Eliminating or reducing maternity wards
Scaling back mental health and substance abuse programs
Pausing specialized treatment for chronic conditions like diabetes and heart disease
Reducing or closing emergency rooms.
These service cuts directly affect patient health and can delay lifesaving treatment.
How many hospitals will be affected?
According to a report conducted by the Center for Healthcare Quality and Payment Reform, (CHQPR) at least 10 hospitals are at “immediate risk of closure,” representing 14 percent of the state’s rural hospitals.
An additional 10 facilities are considered at high risk if the conditions continue translating into almost one in seven rural facilities statewide closing or drastically cutting services.
Hospitals identified as most vulnerable include:
Fannin Regional Hospital (Blue Ridge)
Flint River Community Hospital (Montezuma)
Irwin County Hospital (Ocilla)
Washington County Regional Medical Center (Sandersville).
What will this mean for residents in rural areas?
If a hospital closes or cuts services, patients may have to:
Travel much farther for basic health care, emergencies or childbirth
Wait longer for ambulance service and treatment
Face higher costs
Lose local jobs.
What are health leaders saying?
Leaders at the Georgia Health Association and Georgia Health News have sounded the alarm about the impact of these changes:
“Rural hospitals operate on very narrow margins. Any decline in Medicaid funding places critical access hospitals and the people they serve at risk,” Anna Adams, senior vice president for external affairs at the Georgia Hospital Association said during a news conference in 2023.
The authors of the CHQPR report warn, “Rural hospital closures threaten the nation’s food supply and energy production, because farms, ranches, mines, drilling sites, wind farms, and solar energy facilities are located primarily in rural areas, and they will not be able to attract and retain workers if health care isn’t available in the community.”
For more information
Georgia Hospital Association: www.gha.org
Georgia Department of Public Health: dph.georgia.gov
Rural Health Information Hub: www.ruralhealthinfo.org
The recent changes to Medicaid under the One Big Beautiful Bill Act have introduced new financial pressures for facilities that already were operating under challenging conditions, and residents — in rural and urban areas — are concerned.
What are your thoughts on the upcoming changes to healthcare in Georgia? Email me at srose@ledger-enquirer.com or find me on social media.
This story was originally published July 17, 2025 at 11:57 AM with the headline "Trump’s BBB could close 1 in 7 Georgia hospitals and cost $540M."
