Kevin Stansbury, CEO of rural Lincoln Community Hospital and Care Center, clarifies that the hospital could not survive Medicaid cuts.
Conservative CEO of rural hospital slams Medicaid cuts
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Summary
Conservative hospital CEO Kevin Stansbury tells Morning Joe that proposed federal Medicaid caps championed by Donald Trump and congressional Republicans would bankrupt rural hospitals like his in Hugo, Colorado. Serving an area the size of Connecticut with just two residents per square mile, Lincoln Community Hospital relies on Medicaid to fund unprofitable but essential services such as primary care, long‑term care, home health, and ambulances. If those dollars disappear, patients would face 85‑mile drives to the next nearest facility—an untenable distance for farmers, ranchers, and seniors who already struggle with chronic disease.
- Medicaid lifeline: More than one‑third of Lincoln Community Hospital’s revenue comes from Medicaid, without which basic operations would collapse.
- Unprofitable necessities: Rural hospitals must provide loss‑making services—ambulance, home‑health, chronic‑care management—because private insurers and larger systems ignore thinly populated regions.
- Geographic isolation: If local facilities close, residents would have to travel roughly 85 miles to Denver or Colorado Springs for emergency or routine care.
- State shortfall: Colorado, like most states, cannot replace lost federal dollars; block‑granting Medicaid would force immediate cuts to care.
- Rural political paradox: Trump’s Medicaid cuts target the very red‑state voters who propelled him to power, exposing a gap between right‑wing rhetoric and real‑world health outcomes.
Stansbury’s testimony demolishes the conservative myth that slashing “big government” helps small‑town America; in reality, it endangers working families who grow the nation’s food and fuel. Progressives argue that health‑care equity starts with strengthening—not shrinking—Medicaid, expanding it to cover every rural resident, and ultimately moving toward a universal public system that treats health as a public good rather than a budget line.
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Kevin Stansbury, a self‑described conservative and the chief executive of Lincoln Community Hospital in Hugo, Colorado, did not intend to become a spokesman for government health insurance. Yet his recent New York Times guest essay and appearance on MSNBC’s Morning Joe reveal a hard truth that many Republican lawmakers refuse to face: Medicaid is the financial backbone of rural medicine, and the latest Trump‑aligned proposals to cap or slash the program will accelerate a wave of hospital closures that strikes red America first and hardest.
Stansbury’s hospital serves a frontier county with barely two residents per square mile. It operates ambulance service, home‑health, long‑term‑care beds, and is the only primary‑care clinic in an area the size of Connecticut. None of those services turn a profit; they survive because Medicaid reimbursement plugs the gap left by private insurers that have fled and by Medicare payments that rarely cover the cost. When MSNBC’s Mika Brzezinski asked him what would happen if Congress imposed Trump’s favored block‑grant formula, the answer was blunt: “No one can guarantee we’d keep the doors open.”
His alarm is not hyperbole. According to a new Kaiser Family Foundation brief, 69 percent of rural hospital closures between 2014 and 2024 occurred in states that refused to expand Medicaid under the Affordable Care Act, and closure rates spiked again in 2023 as pandemic relief expired. A companion KFF data set shows 193 rural hospitals have shut down since 2005, erasing maternity wards, emergency rooms, and intensive‑care beds that farmers, truckers, and small‑town retirees once relied on.
The math behind the crisis is straightforward. Rural facilities treat an older, poorer, and sicker population; Medicaid covers a third of their patients, and another third are on Medicare. When Washington pays less than the cost of delivering care, margins collapse. The Center for American Progress warns that block grants or per‑capita caps—options repeatedly floated by Trump budget writers—shift risk to states, which then ratchet down payment rates or restrict eligibility. Rural hospitals, already running on 1‑percent margins, have no cushion to absorb that hit.
Budget analysts at the Center on Budget and Policy Priorities calculate that House Republicans’ 2025 plan would cut Medicaid by $880 billion over a decade, a figure large enough to wipe out entire county health systems. The Washington Post corroborates the human cost: nearly half of rural hospitals now operate in the red, and proposed reductions would shutter labor‑and‑delivery units in states such as Texas, where almost half of counties already lack obstetric care.
Notably, some GOP centrists have begun to rebel. Representatives Don Bacon of Nebraska and Juan Ciscomani of Arizona warn that steep Medicaid cuts would devastate local employers and elderly constituents—an echo of Stansbury’s plea from the prairie. Their resistance underscores a political contradiction: the party that brands itself a champion of small‑town America is advancing a health‑finance scheme that metropolitan hospitals might weather but rural hospitals almost certainly will not.
Progressives seize on this contradiction to argue that Medicaid expansion—and ultimately universal coverage—is not charity but economic infrastructure. Studies consistently show that expansion states experienced fewer hospital closures, higher rural employment, and improved disease management for diabetes and hypertension. Every Medicaid dollar is a subsidy for ambulance crews, radiology equipment, and nursing‑home beds that private markets deem “inefficient” but communities deem indispensable.
Critics on the right claim fraud and fiscal bloat justify the axe. Yet, federal audits estimate improper payments at roughly 8 percent of total outlays—serious but far from the 25‑ to 30‑percent exaggerations that cable pundits repeat. In contrast, the American Hospital Association pegs the replacement cost of a single rural ER visit diverted to an urban center at three times the original price once transportation, staffing, and delayed care are tallied. Those hidden costs boomerang onto state budgets and, ultimately, taxpayers.
Stansbury’s testimony, therefore, offers more than a regional anecdote; it is a warning shot from the frontlines of health‑care austerity. If Washington hollows out Medicaid, small hospitals will close, ambulance rides will lengthen from minutes to hours, and chronic conditions will explode into expensive emergencies. Rural voters may not use policy jargon to describe “per‑capita caps,” but they will recognize when the maternity ward lights go dark.
For progressives, the path forward is clear. First, defend Medicaid from block‑grant experimentation that converts a life‑saving entitlement into a discretionary line item. Second, reward states that finally expand coverage by boosting Disproportionate Share Hospital payments to stabilize fragile facilities. Third, a public‑option or Medicare‑for‑All framework should be advanced to eliminate the rural‑urban funding gap.
Kevin Stansbury closed his interview with a plea: “Support rural communities the way we support America—by keeping people healthy enough to harvest our food and fuel.” In that single sentence, a conservative CEO distilled the progressive argument better than a stack of white‑papers ever could: health care is a public good, and Medicaid is rural America’s lifeline.
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