President Donald Trump’s new tax and spending law will likely force more than half the states to reduce payments to doctors and hospitals that treat Medicaid patients, a change critics warn will be particularly harmful to rural hospitals struggling to stay afloat. Medicaid, the joint state-federal health insurance program for those with a low income, reimburses doctors, hospitals and nursing facilities for treating enrollees. The new law will reduce Medicaid spending by $149 billion over the next decade, and reduce Medicaid provider payments in as many as 31 states.