President Donald Trump signed the $4.5 trillion tax and cuts bill on Friday, which includes cutbacks to Medicaid.

As the United States Senate passed the massive reconciliation bill on Tuesday, local officials’ concerns heightened as Medicaid cuts are just a vote away from being implemented into law. The bill has work requirements and reduction in federal Medicaid spending,

States and rural health advocacy groups are sounding the alarm that Congress’ slashing of Medicaid will devastate already financially fragile rural hospitals. One analysis estimates more than 300 hospitals could be at risk of closing under the Republican measure to slash about $1 trillion in Medicaid funding over ten years.