The Roy Howard Community Journalism Center’s “What Is True?” team investigated a claim from a Southern Poverty Law Center report that more than half of Mississippi’s rural hospitals are at risk of closing due to federal Medicaid cuts. 

RESULTS: Mostly True

The claim that “more than half” of Mississippi’s rural hospitals are at risk is supported by at least one credible methodology. However, the claim doesn’t explain what “at risk” means. Read the full fact-check below: 

The Southern Poverty Law Center released Critical Condition: Rural Health Care Access Following H.R. 1 on May 12. The report warns that 99 rural hospitals across the Deep South could close following federal Medicaid cuts under H.R. 1, known as the One Big Beautiful Bill Act. 

Signed into law by President Donald Trump on July 4, 2025, H.R. 1 cut approximately $1 trillion from federal health care programs, including Medicaid. The Congressional Budget Office projected the cuts would result in millions of low-income Americans losing health insurance. The report says that, with rural hospitals already operating on thin margins, the changes could lead to more uncompensated care for uninsured patients and Medicaid funding shortfalls. 

The CBO estimates H.R. 1 will add $137 billion to rural hospitals’ annual costs. However, the new Rural Health Transformation Fund, enacted after the passage of the One Big Beautiful Bill Act, will cover only $50 billion of those costs. 

Researchers use different methods to determine whether a rural hospital is considered “at risk” of closing. The SPLC report drew on data from the Center for Healthcare Quality and Payment Reform, which labels a hospital as “at risk” if it has sustained negative patient service margins for more than three years. 

By that measure, Becker’s Hospital Review found 36 Mississippi rural hospitals are at risk of closure, or about 54%. Twenty-three of those hospitals face an immediate risk of closure within two to three years. 

However, a separate February analysis by Chartis, a health care consulting firm, put Mississippi’s number of at-risk hospitals at 24. The difference stems from the methodologies: Chartis measures whether a hospital is operating at an overall loss, while the Center for Healthcare Quality and Payment Reform focuses specifically on patient service margins. 

Both analyses cite Mississippi’s decision not to expand Medicaid under the Affordable Care Act as a factor in rural hospitals’ financial challenges. Rural hospitals must treat patients regardless of their ability to pay, meaning uncompensated care can strain hospital budgets.  

Available evidence indicates that some Mississippi rural hospitals face financial risk, but estimates vary depending on how researchers define “at risk.” The claim is supported by one widely cited methodology, but the framing requires context because other analyses produce different estimates. 

About “What Is True?” 

The RHCJC’s “What Is True?” team of graduate investigators examines everything from viral online posts to local community rumors. If you have a question, submit it through the “What Is True?” inquiry form on the RHCJC website or call 855-IS-IT-TRU (855-474-8878).