Opinion: A rural hospital administrator considers what will become of his center if Congress cuts Medicaid

When a rural hospital closes, many residents drive hours to
see a provider or receive specialized care. (Adobe photo)

Over the past 15 years, rural hospitals have struggled to stay afloat, but their already precarious financial state could become a full-blown crisis should Congress slash Medicaid spending. Kevin Stansbury, the chief executive of Lincoln Health in tiny Hugo, Colorado, writes in his opinion for The New York Times, "Congress is considering cuts to Medicaid that could wreak havoc on rural America’s fragile health care system. I worry about our future."

Cuts to federal Medicaid support will be hard on most medical centers, but "rural hospitals will be particularly affected," Stansbury explains. "This is because rural patients are more likely to have health coverage from the government than from commercial insurers. (Nearly three-quarters of our revenue, for example, is from Medicaid and Medicare.)"

In Colorado, almost half of all rural hospitals operate in the red and many have closed services such as labor and delivery units because they are too expensive to run. Stansbury writes, "We also serve fewer patients than big city hospitals but still have fixed costs to stay operational. The result is that we run on minimal or negative operating margins."

When a rural hospital closes, the health of its immediate and surrounding communities suffers. If a severe auto accident happens, victims have to wait longer for emergency services to arrive, or brave traveling to the closest medical center. Residents with chronic conditions are more likely to skip regular care because they must drive hours for a checkup or specialty treatment.

"I know the financial peril my hospital will face if our Medicaid lifeline is severed. But the real damage — the kind that keeps me up at night — will be done to the hardworking people in my rural community," Stansbury adds. "I worry about the residents of our nursing home who just want to grow old here. I worry about the people in Hugo who might forgo care entirely because they can’t get the time off work to visit a Denver hospital. . . .The list goes on."

Cutting Medicaid waste and fraud is one thing "but the cuts on the table go far beyond that," Stansbury writes. "I don’t see waste in Hugo. Rather, Medicaid ensures that primary and emergency care is still accessible here, and that drivers along I-70 will see the blue H on the highway sign and know that help is nearby."