Did these hospitals lose federal funding in 2015 because ACA took away the money for Medicaid?   Are these hospitals not qualified or poorly paid under new Medicaid rules?   Maybe it is a mainland problem, but rural areas always need to pay doctors not insurance that never works.  Looks like 8 years lost to ACA campaigning with no good US medical training programs despite long term doctor shortage.  Sorry this is not a good place for this comment, but it's such a pleasant comments section!