US hospitals lost over 24,000 beds as closures accelerate in urban and rural areas

A study by the Harvard T.H. Chan School of Public Health published in JAMA on October 8, 2026, revealed that U.S. hospital closures increased 4% annually from 2010 to 2025, while openings dropped 3%, resulting in a net loss of 216 hospitals and over 24,000 beds. Urban hospitals closed at a 9.1% rate, surpassing rural closures at 8.3%. For-profit, small, and safety-net facilities in high-poverty areas were most affected, with higher closure rates in states without Medicaid expansion.

Hospital closures accelerating nationwide

• ▪A Harvard T.H. Chan School of Public Health study published in JAMA on October 8, 2026, found U.S. hospital closures increased 4% year over year while openings fell 3% between 2010 and 2025
• ▪Between 2010 and 2025, 432 U.S. hospitals closed and 216 opened, resulting in a net loss of 216 hospitals and over 24,000 hospital beds, according to Harvard researchers
• ▪Of the U.S. hospitals that closed between 2010 and 2025, approximately 73% closed completely while the remainder retained outpatient services such as rural emergency care
• ▪The Midwest and South regions of the United States experienced the highest overall number of hospital closures between 2010 and 2025, according to Harvard researchers

Urban closure rates

• ▪Urban hospitals in the United States closed at a rate of 9.1% between 2010 and 2025, compared to an 8.3% closure rate for rural hospitals
• ▪New hospital openings between 2010 and 2025 were concentrated primarily in urban areas and were mostly small, for-profit facilities

Rural hospital vulnerabilities

• ▪Rural communities in the United States tend to have fewer physicians per capita and smaller overall patient populations than urban communities
• ▪Rural areas in the United States were less likely than urban areas to gain new hospitals between 2010 and 2025 despite an 8.3% rural hospital closure rate

Safety-net hospital closures

• ▪U.S. hospitals that closed between 2010 and 2025 were disproportionately located in counties with higher poverty rates and reduced public transportation access
• ▪Hospitals that closed between 2010 and 2025 were predominantly for-profit, small, or safety-net facilities, according to the Harvard T.H. Chan School of Public Health study

Medicaid expansion impact

• ▪The One Big Beautiful Bill Act is projected to reduce federal Medicaid spending by $886.8 billion over ten years, according to Congressional Budget Office estimates
• ▪States that did not expand Medicaid eligibility under the Affordable Care Act experienced higher rates of hospital closures between 2010 and 2025

Federal spending cuts

• ▪President Donald Trump signed the Republican-backed One Big Beautiful Bill Act in July 2025, introducing broad tax and health spending modifications
• ▪The One Big Beautiful Bill Act, signed by President Trump in July 2025, includes $50 billion in rural health grants over five years, but places strict limits on direct hospital funding

Debatable claims

• ▪Failure to expand Medicaid is the primary driver of safety-net hospital closures
• ▪Urban hospital closures pose a greater public health threat than rural hospital closures
• ▪Congress should directly subsidize unprofitable safety-net hospitals to prevent closures