Hospitals pursue deals to ensure survival as Trump’s Medicaid cuts loom

The article opens in Bogalusa, Louisiana, a struggling town where 40% of residents live below the poverty line and manufacturing has given way to health care as a primary employer. Its hospital, Our Lady of the Angels, has defied the town's decline thanks to backing from a larger health system, which its chief medical officer, Brian Galofaro, calls a 'blessing' that many rural hospitals lack.

Rural hospitals nationwide are now trying to replicate that model. Recent examples include North Star Health Alliance in upstate New York, which is in bankruptcy and discussed partnering with Rochester Regional Health; WVU Health's agreement to acquire Pennsylvania's Independence Health System; Knox Community Hospital in Ohio joining Kettering Health; Baptist Health taking over Magnolia Regional Medical Center in Arkansas; and Novant Health bringing North Carolina's Community Hospital of Stokes into its system.

The push is being accelerated by President Trump's Medicaid cuts, which passed as part of last year's tax bill and are projected to create a federal funding shortfall. Merger-and-acquisition brokers report an uptick in interest from smaller systems, and deal announcements have risen since the cuts passed. Greg Maddrey, president of the consulting group Chartis, said, 'For every deal that's been announced, there are scores being talked about.' He noted that single hospitals and small systems are being forced to consider mergers.

The trend could change the balance of power in U.S. health care, potentially making care more expensive and harder to reach if larger systems consolidate services into fewer locations. But the alternative—hospitals shutting down entirely—could also reduce access to care.