Becker’s has reported on just six planned hospital and emergency department closures so far in 2026. At this point in 2025, Becker’s had already reported on 21.
While some may look at this as a good sign, leaders from four national hospital associations told Becker’s that financial distress hasn’t eased but is manifesting in other ways, such as service line cuts to rural emergency hospital conversions and consolidations. Many expect closures to increase in 2027 as Medicaid cuts and the expiration of enhanced premium tax credits take hold.
Here’s what they said:
Editor’s note: Responses have been lightly edited for clarity and length.
Beth Feldpush. Senior Vice President of Advocacy and Policy, America’s Essential Hospitals: We’re likely to see a rise in both full closures and “quiet closures” due to the Medicaid cuts passed by Congress. Quiet closures are already happening, where a hospital stays open but has to cut beds, critical service lines like maternal care and behavioral health, and staff. The Medicaid cuts facing our hospitals will have a drastic, and very negative, impacts on the way we operate and the care we can provide to the patients who need it the most. Congress and the administration need to protect and support essential hospitals, not target their limited resources.
Brock Slabach. COO, National Rural Health Association: I don’t think the lower number of rural hospital closures necessarily means hospitals are healthier. Many struggling hospitals have found alternatives to outright closure, including conversion to rural emergency hospital status, service-line reductions, affiliations with larger systems, and other restructuring strategies. We’re also seeing more hospitals close obstetrics, behavioral health, inpatient units, nursing homes or standalone emergency departments while keeping the main facility open. In many cases, the distress remains, but it shows up as consolidation and service erosion rather than a full hospital shutdown.
I expect closures to increase somewhat in 2027 over 2026 as hospitals continue to face reimbursement pressures, revenue cycle management disruptions, workforce challenges, and the downstream effects of federal policy changes, especially the impact of HR1. However, I think the bigger story will be continued service reductions rather than widespread hospital shutdowns. Rural communities are likely to see more losses of labor and delivery, inpatient care, and specialty services as hospitals work to preserve core emergency and outpatient access. The question won’t just be whether the hospital remains open, but what services are still available when it does.
Charlene MacDonald. President and CEO, Federation of American Hospitals: The decline in hospital closures tells us more about where we’ve been than where we’re headed. After several years of record low uninsured rates, the expiration of the enhanced tax credits is leaving millions of Americans uninsured or paying more for less comprehensive coverage, driving up uncompensated care. Closures are a last resort, but today’s coverage losses — and those still to come — will put growing pressure on hospitals and the communities we serve.
Ben Teicher. Associate Director, Media Relations, AHA: The effects of the One Big Beautiful Bill Act’s Medicaid cuts will unfold over the coming years, and hospitals also are preparing for the accumulating effects of the expiration of enhanced premium tax credits. Medicaid changes, including changes affecting state-directed payments, could add further pressure, particularly for hospitals and communities that already face thin operating margins.
We’re seeing these pressures play out in other ways as well, including slightly more rural emergency hospital conversions so far in 2026 than in 2025. Those kinds of changes may not show up in a count focused specifically on hospital and emergency department closures, but they are important indicators of how hospitals and health systems are adapting to financial challenges.
