Rep. Jasmine Crockett says that rural hospitals will be hurt most, as Chris Hayes questioned why the powerful hospital lobby is absent from fighting against the Big Beautiful bill. Here’s the answer.
Jasmine Crockett nails a rural hospital truth
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Summary
Chris Hayes pressed Rep. Jasmine Crockett to explain why America’s powerful hospital lobby is missing in action while Donald Trump’s “One Big Beautiful Bill” rips Medicaid dollars out of rural communities; Crockett responded that red-state hospitals will close en masse, and a closer look at the numbers shows the lobby’s silence serves corporate hospital chains that expect to scoop up profits once small facilities collapse.
- Hayes noted the hospital lobby’s historic influence during the ACA fight and asked why it is now invisible.
- Crockett stressed that Medicaid-heavy rural hospitals in GOP-run states will be the first to shutter if Congress enacts Trump’s bill.
- The American Hospital Association (AHA) estimates the bill would strip $50.4 billion from rural hospitals over ten years and push 1.8 million rural residents off Medicaid.
- Researchers for KFF Health News warn that more than 300 rural hospitals, already on thin margins, would likely slide toward closure.
- KFF data show that 69 percent of rural hospital closures since 2014 occurred in states that refused the ACA’s Medicaid expansion, precisely the states cheering the bill.
The episode reveals a harsh reality: corporate health interests profit when public insurance is eroded and rural care deserts expand, but working-class families lose their lifelines. Progressive policy must amplify Crockett’s alarm, defend Medicaid, and put people over profit.
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Donald Trump’s “One Big Beautiful Bill” is a misnomer of Orwellian proportions. Behind the marketing varnish lies a fiscal meat cleaver aimed straight at the Medicaid program that sustains rural America’s fragile hospital network. Rep. Jasmine Crockett highlighted the threat on All In with Chris Hayes. She also revealed that more than a parliamentary skirmish was at stake, illuminating the fact that rural America would suffer more than any other demographic.
To grasp the stakes, start with the numbers. According to a June 16 fact sheet from the American Hospital Association, Trump’s bill would siphon $50.4 billion in Medicaid reimbursements away from rural hospitals over the next decade and cancel coverage for 1.8 million rural residents. Those dollars now underwrite emergency rooms, maternity wards, and oncology units in communities that are older, poorer, and sicker than their urban counterparts. A KFF Health News analysis finds that more than 300 rural facilities—nearly one-in-five nationwide—would be pushed to the brink of closure if the cuts become law.
The crisis did not begin with Trump’s latest gambit. A longer arc illustrates how conservative state governments and hospital conglomerates have, together, eroded the safety net. KFF researchers have documented that 69 percent of rural hospital closures since 2014 have occurred in states that rejected Medicaid expansion under the Affordable Care Act. In effect, lawmakers first withheld life support, and now they prepare to sever the ventilator. Rural voters who were promised freedom from “big government” instead face freedom from local medical care.
Hayes’s question—“Where is the hospital lobby?”—lands at the center of this contradiction. During the ACA negotiations in 2009, the American Hospital Association flooded Capitol Hill with suits demanding reimbursement guarantees. This time, they are missing in action. One can infer that Wall Street believes urban consolidation, rather than rural rescue, drives shareholder value. The silence is likely strategic: large systems expect to absorb profitable nurses, doctors, and patients diverted from closed critical-access hospitals, pocketing Trump’s tax cuts as a bonus.
This Darwinian calculus could explain why the lobby’s rhetoric of access rarely translates into action. Medicaid is indispensable to rural hospitals but accounts for a modest slice of revenue for metropolitan “super-regionals.” Back-of-the-envelope math shows that the median operating margin of rural facilities hovers near 0 percent, whereas urban chains often post margins above 6 percent. Eliminating low-margin outposts and consolidating specialists into city hubs raises corporate returns—even if it forces a stroke victim in West Texas to ride 90 miles for treatment.
Progressives can dismantle this predatory logic by foregrounding three realities. First, public insurance saves lives and local economies. Every rural hospital supports scores of middle-class jobs, anchors physician recruitment, and attracts ancillary services such as pharmacies and imaging centers. Second, Medicaid expansion is fiscally prudent: studies by the Center on Budget and Policy Priorities show that it reduces uncompensated care costs and keeps hospitals open without harming state budgets. Third, universal health coverage—whether through a public option or Medicare for All—would end the false dichotomy between corporate profit and community survival.
Crockett’s appearance also punctures the cultural wedge politics that Republicans deploy to obscure material harm. Rural voters are being “hoodwinked on social issues” while power brokers in Austin and Washington strip away their health infrastructure. The evidence is undeniable: Louisiana risks losing a majority of its rural hospitals under the bill, according to an AHA state breakdown, yet both of the state’s senators cheer the legislation. The disconnect mirrors earlier battles over SNAP, infrastructure, and clean-energy jobs—policies that red-state politicians opposed even when the benefits flowed primarily to their constituents.
What path forward exists? In the short term, Democrats must treat Medicaid cuts as a red-line issue in budget negotiations and mobilize hospital workers, patients, and local business leaders to pressure wavering Republicans. Progressive media outlets and grassroots organizations can amplify stories of communities saved by Medicaid expansion in North Carolina, potentially threatening to replicate the electoral backlash that followed GOP attempts to repeal the ACA in 2017. In the long term, Congress should establish a rural hospital stabilization fund, similar to the Critical Access Hospital program, but funded through progressive taxation rather than block grants, which are susceptible to partisan manipulation.
Hayes posed the right question; Crockett supplied a moral compass. The final answer, however, rests with a public willing to demand that health care be treated as a human right instead of a line item ripe for plunder. A government that can underwrite missile systems can keep a labor-and-delivery ward open in East Texas. The choice is not about budgets but about values, and progressives are making it clear which side of that ledger best serves democracy.
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