How an empty North Carolina rural hospital explains a GOP senator’s vote against Trump’s tax bill

Washington – Although patients no longer rush through the doors of this emergency room, an empty hospital in Williamston, in North Carolina, offers an evocative illustration of the reason why the republican senator Thom Tillis would make his party leaders to vote the signing domestic policy of President Donald Trump.

Martin General is part of a dozen hospitals that have closed in North Carolina in the past two decades. This is a problem that hospital systems and health experts can only worsen if the legislation is adopted with its $ 1 Billion discounts on the Medicaid program and new restrictions on registration for coverage.

The state of original Tillis has the financial impact that more Medicaid dollars can have on hospitals in rural and poor regions of the country. Tillis declared in a floor speech on Sunday, explaining his vote, that the GOP bill sipples billions of dollars from the beneficiaries of Medicaid and the health system of his state.

“Republicans are about to make a mistake on health care and betray a promise,” said Tillis, who announced that he would not ask for his re -election because of his opposition to the bill. With the Republicans Susan Collins of Maine and Rand Paul from Kentucky, he joined all the Democrats to vote against the bill.

Tillis later accused the president and his colleagues not to fully seize the full impact of the bill: “We owe the states to do the work to understand how these proposals affect them. How difficult is it? I did it. ”

For the Martin de Williamston general hospital, the Northern Caroline’s decision to extend Medicaid arrived too late. The emergency room suddenly closed its doors in the east of the County of North Carolina which houses more than 20,000 people in August 2023. The nearest hospital is now about 30 minutes by car.

The Democratic Governor at the time, Roy Cooper, criticized the state’s failure to extend the Medicaid program to adults that are more at low income earlier to prevent the closure of Martin General.

Northern Carolina began to offer Medicaid expansion to its residents in December. Today, more than 673,000 people receive this coverage.

Now Tillis and other representatives of the State fear that the republican bill, which will limit the amount of money from Medicaid referred to providers, again threatens funds for hospitals in their state. And this could trigger a law of state Medicaid which would close the expansion also successful by North Carolina, unless the legislators of the States make modifications or to locate the funds.

The Medicaid dollars that the Republicans seek to retreat in their bill have helped to support the remaining rural hospitals of North Carolina, said Jay Ludlam, assistant health secretary who directs the Carolina of North Medicaid.

“It was a rescue buoy for our rural hospitals here in North Carolina and helped to provide and keep them open,” said Ludlam. “Rural hospitals play an essential role in communities both as an access point to health care, but also for the local economy because of the contributions that these hospital and hospital systems make to these communities.”

The Republicans responded to concerns with a provision that will provide $ 10 billion a year to rural hospitals for five years, or $ 50 billion in total.

Throughout the country, 200 hospitals have closed or closed emergency services in the past two decades, many of which are in the red states across the Southeast and the Midwest of the United States

The states that refused to extend the coverage of Medicaid, the health insurance program for the poorest Americans, have seen the closures accelerate. Tennessee, for example, has lost 500 beds since 2014, when a federal law allowed the states for the first time to extend the coverage of Medicaid to a larger share of low -income people. It is one of the 10 states that has not extended Medicaid.

More than 300 hospitals could be at risk of closing if the bill of republicans becomes Law, an analysis of the Cecil G. Sheps Center of the University of North Carolina in Chapel Hill discovered last month. The center follows the closings of the rural hospital.

“Substantial reductions in Medicaid or Medicare payments could increase the number of non -profitable rural hospitals and raise their risk of financial distress,” concluded the analysis. “In response, hospitals may be forced to reduce service lines, convert to another type of health establishment or close completely.”

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The writer Associated Press Gary D. Robertson in Raleigh, in North Carolina, contributed to this report.