I recall an article in our local paper (Minneapolis-St Paul) on the concerns of outstate hospitals and clinics, especially those in the northern and western part of our state.  Some of the providers and facility managers expressed fears they would become financially unsustainable and would wind up closing, and that people could have to drive 50-70 miles to see a doctor, maybe more to be admitted to a hospital. 

Sorry, I don't remember the date of the article.

I can't imagine rural facilities in other parts of the country, already struggling financially, would have it any easier.