The unprecedented Medicaid cuts that US President Donald Trump and congressional Republicans approved last summer are putting hundreds of hospitals across the country at high risk of cutting services or permanently shutting their doors, a potentially devastating outcome for millions of poor Americans that was repeatedly predicted ahead of time.

The advocacy group Public Citizen released a report Monday identifying 446 hospitals that could be forced to reduce services or close because of the Trump-GOP Medicaid cuts, which will amount to around $1 trillion over the next decade. The at-risk hospitals collectively served 7 million patients in 2024, according to Public Citizen’s analysis.

Nearly 200 of the hospitals listed in Public Citizen’s report are located in congressional districts represented by Republicans who voted for the Medicaid cuts, and 146 are in states represented by Senate Republicans — nearly all of whom supported the sprawling budget package that included the assault on Medicaid.

“Trump’s cuts to Medicaid will hurt millions of low-income and disabled Americans, and will deepen financial strains that are already plaguing rural and safety-net hospitals — compromising their ability to deliver care, potentially leading many to close,” said Public Citizen researcher Eileen O’Grady, the author of the report. “Congress should take urgent action to restore all Medicaid funding cuts enacted by Trump and Republicans in Congress, and should extend the enhanced premium tax credits for coverage through the Affordable Care Act marketplaces.”

The report comes as Republicans are reportedly considering billions of dollars in additional healthcare cuts — and kicking hundreds of thousands more off their health coverage — to help fund Trump’s illegal and increasingly expensive war on Iran.

Public Citizen found in its report that there’s at least one hospital at risk of closing or slashing services in 44 states and Washington, DC. States with the highest proportion of at-risk hospitals are Connecticut, California, New York, Massachusetts, and Washington, the analysis shows.

“It is notable that while there are more at-risk hospitals in Democrat-led states and congressional districts, a substantial number of hospitals in Republican-led states and congressional districts are threatened by Medicaid cuts,” the report observes. “Almost all congressional Republicans voted to pass the Big Ugly Law.”

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