A report by Defend Forgotten America alleges federal healthcare regulators have treated hospital funding programs in Republican-leaning communities differently than similar programs in Democrat-aligned jurisdictions.
In a report obtained by Breitbart News titled “The Bureaucratic Threat to Rural Healthcare,” Defend Forgotten America found that more than 85 local hospital assessments operate nationwide, including at least 63 in jurisdictions that supported President Donald Trump in the 2024 election. The group argued that oversight by the Centers for Medicare and Medicaid Services (CMS) carries significant consequences for rural hospitals and the communities that rely on them.
Defend Forgotten America said rural hospitals are facing financial pressure from staffing shortages, inflation, and reimbursement challenges, citing data showing hundreds of facilities remain vulnerable to closure nationwide.
The organization claims CMS has approved large Medicaid financing arrangements in several Democrat-leaning jurisdictions, including New Jersey, Philadelphia, and Colorado, while applications involving conservative communities in states such as Florida and Ohio have faced prolonged reviews. The report points to Florida’s hospital-directed payment program, which it says remained under review for nearly a year before receiving approval, and an Ohio proposal that has reportedly remained pending for a similar period.
“Data reviewed for this report demonstrates a troubling trend,” the report states.
The report highlighted the strain facing rural healthcare systems in several states. It found that Florida has lost five rural hospitals while three others have converted to emergency-only care, 57% of the state’s rural hospitals stopped offering obstetrics services between 2011 and 2023, and 51% of Texas rural hospitals discontinued chemotherapy services during the same period, including 61 facilities. The report also found that more than 25 percent of Louisiana’s rural hospitals are vulnerable to closure.
Defend Forgotten America called on CMS to expedite reviews of pending waiver and funding applications, establish uniform approval standards, and ensure what it described as equal treatment for communities regardless of political affiliation. The group also urged Congress and federal regulators to protect local provider tax structures that many rural communities use to support healthcare infrastructure.
CMS did not immediately respond to the report’s allegations.
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