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Tuesday, March 21, 2017

Struggling rural hospitals unsure about health bill

Rural residents face increasing obstacles to get medical care, partly because dozens of rural hospitals have closed in the Midwest and South, where Medicaid wasn't expanded under the Patient Protection and Affordable Care Act. Now, if Congress repeals and replaces the law, "Expected cuts to the federal program for low-income residents will affect facilities everywhere, but experts and administrators are particularly worried about rural areas," Russ Bynum, Rebecca Santana and Kathleen Foody report for The Associated Press.

The ACA "was intended to slash the number of uninsured patients seeking care they could never afford at hospitals," reports AP. "It succeeded in rural areas, where overall the rate of uninsured people fell by 8 percent since full implementation of the law in 2014, said Brock Slabach, of the National Rural Health Association. But it fell more in urban areas, in part because of the dearth of choices in the exchanges set up under the ACA. Thirty to 40 percent of rural communities have only one company from which to pick" if they want to buy private insurance.

"Now, as Republicans in Washington put forward long-anticipated plans to get rid of ACA, rural hospitals and communities are watching the debate closely," reports AP. "But if they didn't fare too well under the ACA, many question whether they'd be better off under the plan backed by President Donald Trump."

At some rural hospitals, such as 10-bed Evans Memorial Hospital in Claxton, Ga. (Best Places map), where Medicaid wasn't expanded, "the GOP's new plan isn't calming nerves," AP reports. At Evans, "many blue-collar workers are unable to afford insurance but are too well-off for Medicaid, said chief financial officer John Wiggins. Such uninsured patients are perhaps the No. 1 problem for rural hospitals: Evans Memorial has been saddled with $3 million or more in unpaid medical bills in recent years."

Also, hospital "administrators say they haven't heard much in the proposal that sounds beneficial—besides perhaps the chance to allow Americans to shop for insurance across state lines," AP reports.

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