In the last year, the Bush administration has sought rule changes that would shave $15 billion in the next five years from Medicaid, and the changes have consumed healthcare leaders across the country. Hospital leaders and local government officials across the country say that if Congress doesn't block the regulations, patients will lose. In addition, some say the rule change would force some rural hospitals into the red. In North Carolina, for example, half the state's rural hospitals could run deficits because of the cuts.