Rural hospitals facing cuts in Medicaid will struggle to figure out how to stay open in the coming years, experts said during a recent rural summit. “I feel as though what we see in rural health care is both the best and the canary in the coal mine. “When you cut $800 billion from Medicaid, hospitals, health centers, and nursing homes close. “We only have about 30 days cash on hand, which is not unusual for many rural hospitals. And lastly, he said, rural hospitals are paid less by commercial insurance providers because they have less leverage to negotiate better rates.