Some Pennsylvania hospitals are being pushed beyond the brink of closure.

Taylor Hospital in Ridley Park closed in April 2025, Crozer-Chester Medical Center in Upland closed in May 2025, and Heritage Valley Kennedy Hospital, formerly the Ohio Valley Hospital, in Kennedy Township closed in June 2025.

Rural hospitals are particularly vulnerable.

The UNC Sheps Center, which tracks rural hospital infrastructure in the United States, has documented 195 rural hospitals that have closed or converted to outpatient facilities since January 2005. Six are in Pennsylvania. Closures have far outpaced the opening of new rural hospitals during this period.

As a physician who has trained in rural communities and a researcher who studies community well-being and public health, we see that every rural hospital closure exerts a domino effect on surrounding communities and residents. This can be difficult to quantify but manifests as lost jobs and economic decline, poorer health and a pervasive sense of fraying community fabric.

Our 2022 study found that when a rural hospital closes, hospitals nearby see a measurable spike in inpatient admissions and emergency room visits that can cause significant financial strain. It’s a phenomenon we called “the bystander effect” of hospital closures.

Closures can sometimes feel random, but they are predictable consequences of the combination of health policy and market forces.

Spending cuts and Pennsylvania budget

Recent federal legislation has made the financial outlook for rural hospitals more precarious. The package of tax breaks and spending cuts that President Donald Trump signed into law on July 4, 2025, reduced Medicaid eligibility for Americans and capped federal reimbursements to hospitals and other health care providers.

These reimbursements are a critical revenue source for rural hospitals, which tend to serve large numbers of Medicaid patients.

State officials estimate Pennsylvania could lose about US$20 billion in federal Medicaid funding over the next decade, beginning in 2028, due to the 2025 law. Pennsylvania currently receives $32.6 billion in annual federal Medicaid funding.

Within this complicated and shifting policy landscape, federal and........

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