Friday, October 20, 2017

What ACA repeal would mean for hospital workers' jobs in one rural Arkansas town

Many rural Americans worry that repealing the Affordable Care And Patient Protection Act could cause them to lose not just their health care, but also their jobs. "Funding that began flowing in 2012 as a result of the Affordable Care Act created at least a half-million jobs, according to an analysis by Goldman Sachs," Patricia Cohen reports for The New York Times.

In northern Arkansas, for example, Baxter Regional Medical Center is the town's largest employer, providing 1,600 jobs to a population of 41,000. Since the Affordable Care Act passed, the hospital has added 221 employees. "Without our hospital, I’d probably be working at McDonald’s," hospital employee Beverly Green told Cohen. Her husband, daughter, son, and daughter-in-law all work there too.

Baxter County and most other rural areas of the country voted heavily for President Trump, who campaigned on promises to repeal the ACA. Green and some of her co-workers told Cohen that "the law needed to be fixed, not scrapped. And they primarily blamed a corrupt Washington establishment — not Mr. Trump — for failing to do so."

The law has had a complicated impact on rural hospitals. Arkansas was one of 31 states to extend Medicaid coverage, which made its adult uninsured rate drop 12.3 percent. But Medicare reimbursements were reduced, which meant Baxter gained $4 million in Medicaid payments but lost $12 million through Medicare payments. So Baxter has struggled financially because of the ACA, but would struggle more under proposed Republican remakes, which sought to decrease Medicaid payments without restoring Medicare cuts, Cohen reports. Under the Republican proposals, Baxter Regional would likely have to merge with a larger hospital system, cut back services, and lay off up to 500 employees.

Many other rural hospitals would probably have to close. Rural hospitals have been closing at record rates in recent years, or drastically cutting services in order to stay open.

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