Rural hospitals are facing a financial crisis that threatens many Mississippians' access to doctors, said Dr. Luke Lampton, chairman of the state Board of Health. With increased government costs and drastic cuts in Medicare, "a lot of the rural hospitals aren't going to survive," he said. "Most have low censuses, with poor, elderly and vulnerable patients and are barely making money." With Mississippi opting out of the Medicaid expansion allowed by the Affordable Care Act, hospitals are getting none of the money that would have come with it. Overall, the state would have brought in an additional $2.1 billion, netting the state $431 million, according to a study by The Commonwealth Fund.