House Republicans in Congress approved President Donald Trump's multitrillion-dollar tax breaks and spending cuts bill in a narrow vote Thursday, overcoming setbacks to pass Trump's signature second-term policy package before a Fourth of July deadline.

A Republican megabill cuts $1 trillion from Medicaid, risking closures for hospitals that serve some of America’s most vulnerable. Rural hospitals in the U.S. already operate on a razor’s edge, but new cuts to Medicaid in the Republican appropriations bill could tip many of them into failure.

States and rural health advocacy groups are sounding the alarm that Congress’ slashing of Medicaid will devastate already financially fragile rural hospitals