Thursday, January 12, 2017

Repealing health reform could kill struggling rural hospitals, many in areas Trump carried

If Congress repeals the health-reform law, struggling rural hospitals, many in regions that strongly supported Donald Trump, could be in danger of shuttering, Shefali Luthra reports for Kaiser Health News. The Patient Protection and Affordable Care Act "threw a number of life-savers to these vital but financially troubled centers. And its full repeal, without a comparable and viable replacement, could signal their death knell."

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Luthra's example is Highlands Hospital in Connellsvillea poor rural town in Southwest Pennsylvania, which has struggled with the loss of coal mining and manufacturing jobs. Trump won Fayette County with 64 percent of the vote. Without Obamacare's expansion of Medicaid, the 64-bed hospital, the town's second largest single employer, could close, costing the town hundreds of local jobs.

"In Pennsylvania, 625,000 people enrolled in the expanded Medicaid program," Luthra writes. "Close to 300,000 came from rural areas, said Andy Carter, president of the Hospital and Health System Association of Pennsylvania. As of October, about 42,700 of Fayette’s residents had Medicaid, according to state data, an increase of about 8 percent from 39,460 in June 2015. (Pennsylvania‘s Medicaid expansion took effect in January of that year.) That’s close to one-third of the county’s population."

"Rural hospitals have long operated on the edge," Luthra writes. "In the past six years, more than 70 such facilities have closed, citing financial duress. Almost 700 more have been deemed at risk of following the same path. Meanwhile, the need for reliable health care remains pressing. Conditions such as heart and lung disease are widespread in rural areas. Addiction to the prescription painkillers known as opioids is acute. Nationally, the Medicaid expansion offered a bit of stability for some rural hospitals at risk of closure. Researchers say it disproportionately benefited such facilities—particularly here and other states with large rural populations, such as Illinois, Kentucky and Michigan."

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