How Medicaid cuts could impact rural hospitals : NPR

Juana Summers, host:

Republican legislators run to adopt the President Trump’s national bill before July 4. One of the many key obstacles dividing the Republican senators is Medicaid, with hundreds of billions of dollars in potential discounts on the table.

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Thom Tillis: What should I say to 663,000 people in two years or three years when President Trump breaks his promise by pushing them from Medicaid?

Summers: He is the republican senator Thom Tillis of Caroline du Nord speaking in the Senate yesterday a few hours after having announced that he would not ask for re -election. Rural America is ready to be greatly touched by these proposed cuts. About 20% of the American population lives in rural areas where Medicaid covers 1 in 4 adults. Here, to talk about what could be at stake for these communities, Sarah Jane Tribble. It is the main rural correspondent of Kff Health News. Hi.

Sarah Jane Tribble: Hi there. Thank you for doing me.

Summers: Thank you for being here. Sarah, simply start if you can tell us a bit what you heard from people from rural communities through this country about these proposed cuts.

Tribble: Yes, I don’t hear good things. They are very worried, because Medicaid levels are so high in rural America, that these cuts will be very harmful, they will make more hospitals close, they will tax rural health clinics. I was sitting next to a CEO of a rural hospital in Colorado. He has a 25-bed critical access hospital, the only hospital between the Kansas and Denver border on the colorado i-70 corridor. And he had spoken of the cuts and not satisfied with them. And then we heard of the rural transformation fund on which the Senate worked to help compensate for the cuts. And he leaned and he laughed. He just said, that won’t be enough. So I think there are a lot of concerns in rural America.

Summers: Give us some details on some of the types of ways in which rural hospitals could be affected. For example, I guess I try to understand how these cuts would work and what they would mean for patients.

Tribble: Well, for rural hospitals, they are specifically already at stake. We have had more than 150 hospitals which have completely closed or closed their beds for patients hospitalized since 2010, according to a C Carolina du Nord. 267 other rural hospitals have closed their obstetrics from 2011 to 2021. So these hospitals are already, you know, showing signs of constraint under the current economy of the health system, if you want. And really, the congress has recognized it over the years, spending a new law on the rural emergency hospital a few years ago, trying to help consolidate these hospitals.

Summers: Now, the Senate Republicans have offered to specifically add a fund of $ 25 billion for rural hospitals. But, Sarah, is it enough money to really fill the financing gap that we see here?

Tribble: I hear experts and organizations that it is absolutely not. The Rural National Health Association estimates that it represents only 43% of what is necessary for rural hospitals to compensate for the cups to come in the Senate proposal, and even worse, that this rural transformation fund will not be simply in rural hospitals. He will go, you know, health clinics and federal skilled health centers, community health and opioid treatment centers, according to their estimates. So they really don’t think it’s enough to compensate for it.

I should note that I was talking to the chief lobbyist of the Rural National Health Association this morning. You know, they like the idea of ​​a rural transformation fund because rural America needs it. They need new ways to think about how to provide care in rural America, what type of suppliers should have there, but that certainly does not compensate for the sections to come to the program.

Summers: The White House released an information sheet yesterday pointing out that the bill will not cut Medicaid. This information sheet calls for a myth that the bill will close rural hospitals. How do you analyze these statements?

Tribble: Yeah. So, when you talk to anyone, say, Georgetown or some of the other experts, they have analyzed the number of people who use Medicaid in rural America – let’s say, mothers, working age adults. They are patients in these hospitals. And if you decrease the number of people who receive Medicaid in rural areas, you will reduce the amount of income that hospitals and clinics get because they just have fewer paid patients.

But also, there are other provisions in the bill that you know, the experts have analyzed with regard to the work requirements and the supplier taxes and the state -run payments. These all strike rural America in different ways, in particular states of expansion. So you know, when I – as a journalist, when I analyze it, I call the experts and I ask them questions, and they tell me that it will harm these hospitals and these rural communities.

Summers: Sarah, as you have pointed out, rural hospitals have been in decline for years, many of which have closed in recent decades, which faces the risk of immediate closure. I wonder, what does it all mean for patients? I have heard of how these closures are particularly problematic, for example, for trauma care, the treatment of cancer.

Tribble: Yeah. So I made a lot of reports over the years when I talk to patients who travel long distances for their care, right? I made a story on the new mexico where they created tele -anted services after a hospital closed its obstetrics so that patients do not have to drive for each prenatal visit, right? These are therefore situations that are already somehow at the edge of the edge, if you want, where patients must travel long distances when they deliver babies, or even for trauma care, where helicopters must present themselves and browse important distances to bring people to worry about it. And it is because rural hospitals have finished and rural care, in general, decreased in the past two decades. There are many places where there are simply not enough suppliers in general. And when a firm rural hospital, you know, providers tend to leave the area.

Summers: Sarah Jane Tribble is the main rural correspondent for Kff Health News. Thank you so much.

Tribble: Thank you for inviting me.

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