Plans by Senate Republicans to scale back a Medicaid provider tax that states like Iowa use to fund their Medicaid program could deal a greater financial blow to rural hospitals, state and national hospital groups warn.

Senate Republicans say they are looking for ways to safeguard rural hospitals from proposed cuts to a key Medicaid funding method, amid concerns from the powerful hospital lobby and others that the budget reconciliation bill could force many facilities to close.

Without changes to the GOP's "big, beautiful bill," Sen. Josh Hawley fears "there’s going to be a lot of rural hospitals in Missouri that close."