Critical Condition: Michael Topchik on Rural Hospitals, ACA Turmoil, and America’s Health Care Divide

Bill Bernardoni sits down with Michael Topchik, Executive Director of the Chartis Center for Rural Health, for an urgent and eye-opening conversation about the state of rural hospitals across America. Michael explains how shutdown uncertainty, expiring ACA subsidies, and looming Medicaid cuts could push already-fragile facilities toward closure — and what that means for the communities that rely on them. From defining what “rural hospital” actually means, to the economic devastation that follows closures, to the growing workforce crisis hitting rural America hardest, this segment breaks down why access, affordability, and staffing are reaching a breaking point. A critical look at a healthcare system on the brink in communities too often overlooked.

Should Congress step in with stronger support for rural hospitals — or should struggling facilities be left to fail as the system reshapes itself? Let us know your thoughts in the comments.

Follow Bill on X at @BillBernardoni, explore his work at Bernardoni.media, and read his latest writings at Bernardoni.blog. Learn more about Michael and The Chartis Center by visiting chartis.com/.