Rural hospitals say they’re being forced to consider tough choices after President Trump signed into law a domestic policy bill that includes cuts to Medicaid and Obamacare.

States and rural health advocacy groups are sounding the alarm that Congress’ slashing of Medicaid will devastate already financially fragile rural hospitals. One analysis estimates more than 300 hospitals could be at risk of closing under the Republican measure to slash about $1 trillion in Medicaid funding over ten years.