Very likely going to be a focused rural and birth center hit. Rural hospitals have a 60% reliance on Medicare/Medicaid as their baseline income stream. Even then, Medicaid benefits never cover the actual cost of giving birth, only a portion.

Major urban areas lean on the 30% side for Medicare/Medicaid dependence. Again, it’s all about the capacity to provide things like cardiac cath lab, gastric bypass, knee replacement, etc. All the specialty areas that require specialty doctors to want to live in the area. They won’t close.

There was already a wave of downsizing and penny pinching in response to the Big Betrayal Bill passing. Layoffs. Closures of less lucrative units. Less new grad hires. Weekend programs dissolving. Ancillary staff like supply runners, housekeeping, phlebotomy, transport, the people who answer the phones, all cut back by both position # and hours. A lot of night shift in transport and supply were laid off. And dietary. Forget selecting, you get what you get and don’t eat if you don’t like it. Even nurses were cut.

All of that in quiet anticipation.

But yes, your rural hospitals, especially birth centers, will likely close.