|Senate Majority Leader Mitch McConnell (Associated Press photo)|
Alan Morgan, chief executive officer of the National Rural Health Association, told Marema that the organization will oppose the Senate bill because the legislation will hurt rural America. "In its current form, this bill is anti-rural," Morgan said. The bill contains several provisions that would hit especially hard in rural areas, Marema says. "Among these are deep cuts in Medicaid spending and an end to Medicaid expansion. About 45 percent of rural children use Medicaid, compared with 38 percent in metropolitan areas, according to a Georgetown University study. The bill would reduce funding for treatment of opioid addiction, another issue for rural America," Marema writes.
The rate of opioid overdose deaths is 45 percent higher in rural counties, according to the NRHA. The Senate bill provides $2 billion to fight opioid addiction in 2018, while the House version of the bill would have provided $45 billion over 10 years.
Rural hospitals will continue to be at risk of closure under the new bill, Marema writes. One analysis finds that 673 rural hospitals are vulnerable to closure. Since 2010, 79 rural hospitals have closed, according to tracking by the University of North Carolina.
"Morgan also noted one part of the bill that probably won’t attract much attention but ought to," Marema writes. "The bill zeroes out the Public Health and Prevention Fund, which has been used to fight the zika virus, a mosquito-borne disease that can cause severe birth defects. " Morgan said, "There is a real concern that zika is going to reemerge this summer in rural communities along the southern border. From a rural public health standpoint it’s a real problem."
"This bill is going to hit rural America like a wrecking ball," Sen. Ron Wyden (D-Ore.) said at a hearing Wednesday.
The Washington Post has a side-by-side comparison of the two bills and the Patient Protection and Affordable Care Act.