The column below reflects the views of the author, and these opinions are neither endorsed nor supported by WisOpinion.com.
Passage of the so-called Big Beautiful Bill (BBB) by the GOP-led Congress and signed by Trump in 2025 exacerbated the worsening rural health care crisis in America, including in Wisconsin. “Overall, the BBB cuts taxes by $4.5 trillion over the next decade, primarily with $2.3 trillion of provisions that deliver most of their benefits to the richest 10 percent … ” (Center for American Progress). BBB also slashed the Affordable Care Act (ACA), Medicaid and higher education federal loans for medical and nursing students (fewer needed health professionals for rural areas).
The Congressional Budget Office predicted that BBB health care cuts would result in 17 million losing health coverage over time, including 276,000 Wisconsinites. And, the BBB failed to extend ACA enhanced premium tax credits. GOP senators, including Wisconsin Senator Ron Johnson, filibustered attempts by Democrats and a few Republicans to fix this problem. Already ACA enrollment nationally has dropped more than 1 million, including over 22,000 Wisconsinites. Future GOP changes, including a shortened ACA enrollment period, more red tape and the end of automatic enrollment will cut much deeper. Medicaid will also see decreased enrollment because of burdensome eligibility requirements, roadblocks to states trying to pay for Medicaid costs and needless work requirements.
All of the above means big trouble for rural hospitals. 27 percent of farmers and ranchers are covered by ACA private insurance and others by Medicaid. Cutting health care coverage will be disastrous financially for rural hospitals. The Center for health care Quality and Payment Reform (CHQPR) said: “More than 700 rural hospitals – one-third of all rural hospitals in the country – are at risk of closing because of the serious financial problems they are experiencing.” This includes 12 Wisconsin hospitals, 5 at immediate risk. The Wisconsin Medical Society has also sounded the alarm: “Rural health care is already in crisis across the country and these (coverage) cuts will exacerbate the rural hospital and nursing home closures …, and the access to care challenges as more providers are forced to leave.”
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CHQPR stressed the impact of hospital closures: “Most at-risk hospitals are in isolated rural communities, where closure of the hospital would force residents of the community to travel a long distance for emergency or inpatient care. … In addition, rural hospital closures threaten the nation’s food supply and energy production, because farms, ranchers, 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.”
Wisconsin Democratic Senator Tammy Baldwin and 3rd CD Democratic candidate Rebecca Cooke have solutions. Both want higher Medicare and Medicaid reimbursement rates “to keep our rural hospitals open” and a reversal of the BBB health care coverage cuts. Baldwin said: “Wisconsinites deserve so much better.” While Cooke said: “Rural hospitals are holding on by a thread. We need leaders to heal our health care system, not play roulette with people’s lives.”
Rural health care is dangerously near a breaking point. Vote Democratic in November. People’s lives depend on it.
Kaplan wrote a guest column from Washington, D.C., for the Wisconsin State Journal from 1995 – 2009.
