Flooding from Hurricane Helene forced a dramatic rooftop evacuation at a rural Tennessee hospital last year, but efforts to rebuild the facility now face collapse due to deep health care cuts in President Donald Trump’s sweeping tax and spending bill.
Ariel Wittenberg reports for E&E News.
In short:
- Ballad Health’s CEO vowed to rebuild Unicoi County Hospital after it was inundated during Hurricane Helene, but changes to Medicaid funding under Trump’s “One Big Beautiful Bill” threaten that plan.
- The law slashes provider taxes that many states use to boost Medicaid payments to rural hospitals, which could leave more than 300 such facilities at risk of closure nationwide.
- Although the law created a $50 billion rural hospital fund, hospital leaders say it won’t make up for the cuts, and some lawmakers who voted for the bill now support rolling back its Medicaid provisions.
Key quote:
“It will force hospitals to make service line reductions and staff reductions, resulting in longer waiting times in emergency departments and for other essential services, and could ultimately lead to facility closures, especially in rural and underserved areas.”
— Rick Pollack, president of the American Hospital Association
Why this matters:
Rural hospitals are often the only source of emergency care for miles in communities already underserved by the health care system. They operate on thin margins and rely heavily on Medicaid reimbursements and provider taxes to stay open. When a major facility like Unicoi County Hospital is destroyed — by climate-driven disasters like extreme flooding — and rebuilding is stalled by federal budget cuts, entire regions can lose access to lifesaving care. These closures disproportionately impact low-income, elderly, and medically vulnerable populations. As climate change increases the frequency of extreme weather events, pressure will mount on the already fragile rural health infrastructure.
Read more: Hurricane survivors in Appalachia rebuild as distrust in government and science grows
