Large cuts to Medicaid in the massive tax and spending plan that Republicans are finalizing could deal a major blow to Arizona’s rural hospitals, threatening services for tens of thousands of residents.

Trump’s “big, beautiful bill” could leave thousands without care in Arizona and shutter five rural hospitals.

The bill signed into law on July 4, will affect hundreds of thousands of Arizonans currently enrolled in Medicaid, particularly childless adults, due to newly-added work and documentation requirements. University of Arizona associate vice president Dr. Daniel Derksen, director of the Arizona Center for Rural Health expects cuts and predicts a cascade of problems, including hospital closures, personal bankruptcy and delayed care. "You can't get to $1 trillion in savings without throwing a lot of people off," he said. "You can't do it unless you eliminate coverage or reduce the federal Medicaid funding to states."