Sure thing: Rural hospitals rely heavily on Medicaid payments, because most people in rural areas do not have much money, so the uninsured population is higher; also, the population densities are lower, so fewer people to support the hospital.
But thanks to Medicaid expansion (the Affordable Care Act, aka Obamacare), those uninsured people were able to get coverage, which allowed rural hospitals to recover costs for care. Otherwise, they just eat the costs.
North Carolina lost 11 rural hospitals across the state in the 2010s, because Republicans refused to expand Medicaid. It was (and is) a disaster. If the GOP kills Medicaid expansion now, as the OBBB budget does, a major financial pillar for those hospitals disappears again.
Please explain how the bill results in rural hospitals closing. Thanks.