Why are rural hospitals closing?

THOMASVILLE REGIONAL MEDICAL CENTER WAS SUP- posed to be a game changer. Situated in the U.S. congressional district with the worst health outcomes in the country, the hospital opened in 2020 with state-of-the art equip- ment, including a 3D mammogram and an MRI scanner. But it closed less than five years later in September 2024.

- BY ALANA SEMUELS/THOMASVILLE, ALA.

The hospital now stands empty: its pristine hallways dark, its expensive machines gathering dust. “It’s almost like the apocalypse happened,” says Thomasville’s Mayor Sheldon Day, who worked for almost a decade to get a hos- pital to open there.

This apocalypse is happening throughout the country. More than 100 rural hospitals have closed in the past de- cade, according to the Center for Healthcare Quality and Payment Reform (CHQPR), a national policy center that works to improve health care payment systems. About one- third of all rural hospitals in the country are at risk of closing because of financial problems. In Alabama alone, 23 rural hospitals—about half of the number in the whole state— are at immediate risk of closing, according to CHQPR.

Even more are in trouble with the passage of the sweeping new federal budget reconciliation law, which in- cludes cuts that will slash Medicaid spending in rural areas. Thom Tillis, the U.S. Senator from North Carolina who voted against the bill, said in a June 28 statement that Congress should achieve the cuts in the legislation “with- out hurting our rural communities and hospitals.”