Amid wide healthcare cuts, a bright spot for rural hospitals
Marketplace All-in-One
Marketplace
4.5 • 1.4K Ratings
🗓️ 2 January 2026
⏱️ 8 minutes
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Summary
Healthcare costs are climbing for many Americans as enhanced Affordable Care Act tax credits roll back, raising premiums for middle-income households unless Congress intervenes. In this vacuum, we look at a major new federal investment aimed at expanding healthcare access in rural communities. Plus, U.S. travel is sending mixed signals this year — domestic travel is booming, but fewer international visitors are visiting the States, and that shift is being felt by America’s museums.
Transcript
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| 0:00.0 | Not the sort of exhibit museums embrace, fewer visitors. |
| 0:06.7 | I'm David Brancaccio in Los Angeles. |
| 0:08.6 | First, we've been covering big jumps kicking in now to the cost of health care |
| 0:12.6 | with the rolling back of tax credits for Affordable Care Act plans. |
| 0:17.0 | Many middle income people will feel this. |
| 0:19.6 | Another of the many changes to health care in this new year, expansion of the health care ecosystem outside cities and burbs. It's $50 billion in federal money for what's called the Rural Health Transformation Project. Marketplace's Elizabeth Troval reports. People in rural areas have worse health outcomes, and their hospitals are |
| 0:38.8 | struggling to stay open. The now expired, enhanced premium tax credits were helping, on average, |
| 0:46.0 | $900 annually per person enrolled. Allison Davis is with the Center for Economic Analysis of Rural |
| 0:51.8 | Health. It helped rural residents because it made their access to care |
| 0:55.2 | more and affordable. It helped rural communities because the hospitals within those communities |
| 1:00.0 | were now being compensated for the care they were providing. It was money flowing through the local |
| 1:05.6 | economy. Without it, budgets are going to have to adjust, says Carrie Henning-Smith with the University of Minnesota Rural Health Research Center. |
| 1:13.9 | Does that mean that you're making choices between paying for housing, paying for food on your table, or paying for health insurance? |
| 1:22.1 | We shouldn't have to make these choices, but we do. |
| 1:25.4 | But billions of new dollars will be going towards boosting rural health care |
| 1:29.5 | ecosystems. And Henning Smith says she's excited about initiatives like technological investment, |
| 1:35.8 | partnership building, training opportunities. But she says they don't make up for the losses. |
| 1:41.1 | Rural communities will feel from the expiration of tax credits |
| 1:44.5 | and Medicaid cuts. Alison Davis agrees. It's just too little too late. Davis says it's good |
| 1:51.8 | to invest in the future, but rural hospitals and their patients are already struggling today. |
| 1:57.9 | I'm Elizabeth Trofal for Marketplace. A new study finds 8% fewer women directed the |
| 2:05.0 | top 100 movies in theaters in 2025. This from a University of California study. In fact, |
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