2020 Dems put spotlight on rural hospital closure crisis More than 100 rural hospitals have closed in the U.S. since 2010 and another 430 are at risk of closing, causing a ripple effect in communities across the country. As the 2020 Democratic candidates make their case to rural voters, many of whom live in states that hold early primaries and caucuses, different proposals are being sold as the solution to this growing crisis. Voters in rural Iowa say healthcare access is one of their top concerns and will play a major role in who they vote for in the upcoming February caucus.