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James Myall is an economic policy analyst at Maine Center for Economic Policy.
If Republicans in Congress pass their reconciliation bill, rural Mainers might soon have to drive hours just to see a doctor, or call 911 and pray the ambulance makes it in time.
New reports from the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill and Families USA show more than 300 rural hospitals across the country, including four right here in Maine, could permanently shut down if lawmakers slash Medicaid funding.
Why are these hospitals so vulnerable? Because Medicaid keeps their doors open. Rural hospitals don’t have the big-city patient traffic or piles of private insurance dollars. They rely on Medicaid, and when Congress cuts that lifeline, hospitals are forced to make brutal choices: cut services, lay off staff or close altogether. With Congress now pushing to cut more than $1 trillion from Medicaid and the Affordable Care Act and triggering another $500 billion in Medicare cuts, it’s no wonder hospitals are panicking.
The Sheps Center lists Northern Light A.R. Gould Hospital in Presque Isle (formerly Aroostook Medical Center) and Maine Coast Memorial Hospital in Ellsworth among 338 hospitals nationwide that are either heavily reliant on Medicaid or have reported operating losses over the past three years. Both Maine hospitals made the list due to their recent history of financial losses. Meanwhile, Families USA adds Cary Medical Center in Caribou and Calais Community Hospital to the list of at-risk facilities, estimating proposed Medicaid cuts would push their operating margins below zero.
Northern Light A.R. Gould isn’t just any hospital — it’s the largest employer in Aroostook County, with more than 1,100 workers and 300,000 patient visits a year. If it closes, it’s not just bad — it’s catastrophic. Maine Coast Memorial Hospital is the second largest employer in Hancock County and serves 20,000 patients. Cary Medical Center and Calais Community Hospital are smaller but still employ hundreds of workers each and serve tens of thousands of patients each year.
If any of these hospitals shut down, thousands of people would have to travel farther, sometimes hours, to get emergency care. That’s time they don’t have in a real emergency. Stroke? Heart attack? Complicated pregnancy? The clock is ticking, and rural roads aren’t always fast.
This isn’t just about four hospitals. Data shows many rural hospitals in Maine get just as much of their funding from Medicaid. Many of them are barely breaking even, and a few are already in the red. One big cut from Congress could send them over the edge.
Some of that is already happening.
In May, Inland Hospital in Waterville closed completely. And between 2020 and 2024, five hospitals in Maine shut down their maternity wards. That means pregnant moms have to drive much farther for check-ups or to give birth. That’s not some future warning; it’s right now.
Mainers are proud, resilient and tough — but everyone needs hospitals. We need doctors, nurses and ambulances that actually show up. We need maternity care close to home, not two hours away. If Congress goes through with this reckless budget, rural Mainers will lose access to life-saving care. And once a hospital shuts down, it’s almost impossible to bring it back.
Cutting Medicaid doesn’t just harm patients. It hits workers, families and entire local economies. Hospitals are often the biggest, and sometimes only, major employer in small towns. When they close, the ripple effect is massive: lost jobs, closed businesses and shrinking communities.
Maine’s rural communities can’t afford to lose another hospital. Congress needs to pull the plug on these cuts, not on our hospitals.
