# Collateral Damage: How Medicaid Cuts Under the One Big Beautiful Bill Act Threaten Rural Radiation Oncology

## TL;DR

This paper discusses how Medicaid cuts under a new law could worsen cancer care access in rural areas.

## Contribution

The paper highlights the specific risks Medicaid cuts pose to rural radiation oncology and proposes policy solutions.

## Key findings

- Medicaid cuts may destabilize rural hospitals already struggling with limited oncology resources.
- Reduced coverage could lead to longer cancer diagnosis and treatment delays in rural areas.
- Workforce challenges in rural oncology may be intensified by the policy changes.

## Abstract

Rural communities face longstanding gaps in access to cancer care, and many hospitals continue to operate with limited oncology staffing and services. With the One Big Beautiful Bill Act introducing major Medicaid cuts, these fragile systems may come under greater pressure. This editorial examines how reduced coverage could further destabilize rural hospitals, widen delays in cancer diagnosis and treatment, and intensify workforce challenges, while also outlining policy approaches that might help preserve access for patients who already face the steepest barriers.