A Hospital Crisis Is Growing in Pennsylvania
25 hospitals have closed – with more closures on the way given the nearly $1 trillion in federal Medicaid cuts
In Pennsylvania:
25 hospitals have closed since 2016.
Up to 14 more could reduce services or close within the next five years.
51% of hospitals operate below sustainable margins.
37% are already operating at a loss.
Why is this happening?
Trump’s “One Big Beautiful Bill Act” cuts nearly $1 trillion from Medicaid over the next decade and tightens eligibility requirements, reducing coverage and payments for care patients still need.
At the same time, Medicaid reimbursement in Pennsylvania doesn’t cover the full cost of care. Hospitals receive about $0.87 for every $1 they spend on inpatient and outpatient services, leaving a funding gap.
Medicaid provides coverage for nearly 1 in 4 Pennsylvanians, but these cuts affect everyone. Hospitals lose revenue, uninsured rates rise, and health outcomes worsen, driving up private insurance premiums.
Hospital closures also mean people must travel farther for care and rely on hospitals with fewer emergency and specialty services.
Rural communities are hit the hardest, as they already operate on tighter budgets, have older populations, and rely more heavily on government-funded insurance. When these hospitals close, access to care disappears for entire regions.
But Pennsylvania isn’t the only state where hospitals are closing.
Communities across the country are facing the same reality as hospitals reduce services or shut their doors entirely.
Looking for an online community where you can talk more about how these cuts impact your life? Download the Red Wine & Blue app and join the conversation.
The 87 cents number is the part that gets past people. Sounds close enough to break even. But hospitals don't run on averages, they run on their worst payer mix. A rural ER where Medicaid is 40% of volume isn't losing 13 cents on the dollar, it's losing the margin that covers everything else.
And closures don't announce themselves. Services get cut first. Labor and delivery goes quiet, ER hours shrink. By the time the building shuts, the hospital was already gone.
That 51% below sustainable margins, actually, that's the number that should lead.