North Carolina Senate leader Phil Berger has been adamant: He will not support the Medicaid expansion that's provided through the Affordable Care Act. In fact, he's used his considerable power to block all attempts at expansion.
And now, his hometown hospital in Eden, Morehead Memorial Hospital, has filed for bankruptcy. It's a Chapter 11 filing that will give the hospital some breathing room as it tries to reorganize its finances. The 108-bed hospital opened in 1960. It also operates a nursing center, eight medical practices and a birthing center. The hospital says is it looking for a "strategic partner," which likely means it hopes to be bought by a bigger hospital or group.
Medicaid isn't the whole story in the bankruptcy, of course. It's seldom that simple. Morehead also faces the same problem that other small, rural hospitals deal with: competition with bigger hospitals in their region. But Medicaid reimbursements at Morehead are down and that's one of the reasons for the bankruptcy, hospital President Dana Weston says.
Medicaid reimbursements are invariably a factor in hospital closures and bankruptcies. It's a too-common story across the country, especially in the states that refuse to expand Medicaid, even though federal funding would have covered most of the expense. Rural hospitals in 25 states have closed since 2010, most of them in the South. Thirteen have closed in Texas alone, eight in Tennessee, six in Georgia, and five apiece in Alabama and Mississippi.
Here in North Carolina, the death toll stands at three: Blowing Rock Hospital, Vidant Pungo Hospital in Belhaven and Yadkin Valley Community Hospital in Yadkinville. Expanded Medicaid might have saved many of them. Belhaven Mayor Adam O'Neal walked to Washington last year to publicize his community's health care plight. O'Neal cited cases in which people died because hospital care was so far away.
Nobody in Washington gave O'Neal any hope of change, nor did anyone in Raleigh. In truth, the situation looks even more bleak today. As Congress attempts to repeal and replace the Affordable Care Act, it is moving toward ending Medicaid expansion as an option for any states that haven't already done it, and the health care legislation unveiled in the Senate last week would also shrink Medicaid funding by about 30 percent over the coming years. This guarantees a growing funding crisis even for good-sized hospitals in lower-wealth communities and increases the likelihood that many more rural hospitals will shut down, or at least go into bankruptcy as Morehead Memorial did last week.
Health care represents about a sixth of the American economy, yet most efforts at improving it are aimed at cutting spending, not making the American people healthier. For all of its faults — and they are many — the Affordable Care Act was rooted in an effort to improve Americans' health, getting more people the preventive health care that they need. Congress appears to be ready to be focusing on cost-cutting — not through creating greater efficiencies or by cutting costs, but by simply leaving the health care system as it is and simply shrinking federal funding.
If you want to see where that leads, just visit the communities where hospitals have already had to shut down.
REPRINTED FROM THE JACKSONVILLE DAILY NEWS