Alabama hospitals—especially the State’s rural hospitals—have struggled with thin margins and low reimbursements since long before the pandemic. Now, as the “One Big Beautiful Bill Act” — popularly known as the “OBBB” — becomes law, hospital leaders face new questions over its effects on rural care and coverage gaps.
The OBBB, signed July 4, 2025, packs sweeping tax cuts and Medicaid rollbacks, alongside a $50 billion Rural Health Transformation Program designed to offset Medicaid losses for rural providers.
Danne Howard, President and CEO of the Alabama Hospital Association (AHA), said her group is still wrestling with what the bill means for Alabama…