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Rural Hospitals Close As GOP Governors Refuse Medicaid Expansion

POSTED BY: NIKI2
UPDATED: Friday, January 10, 2014 13:05
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Friday, January 10, 2014 1:05 PM

NIKI2

Gettin' old, but still a hippie at heart...


In what is becoming a sad testament to the dangers of political brinkmanship, hospitals all across the nation are having to close their doors simply because their GOP governors refuse to expand Medicaid. Advisory.Com reports that only 25 states and Washington, DC have approved the ACA Medicaid expansion; 21 have outright refused it; and four states are still thinking about it.
Quote:

Earl Whiteley, CEO of Calhoun Memorial, cited the increase in charity care that the Calhoun County hospital incurred as a major reason for the hospital’s demise.

He told GHN on Monday that indigent charity care rose from $834,000 in 2008 to $1.8 million last year.

“You just can’t continue to give away free care,’’ Whiteley said.

He also noted that the federal Affordable Care Act (ACA) is removing indigent care funds that go to hospitals. As originally envisioned under the ACA, the uninsured patients affected by that cutoff were to get coverage through Medicaid instead. But the U.S. Supreme Court ruled last year that states don’t have to expand Medicaid to cover such people, and Gov. Nathan Deal says Georgia won’t do it because it’s too costly.

Calhoun County has an 18 percent unemployment rate, and Whiteley added that even patients with insurance had high deductibles, ranging from $1,500 to $5,000 a year. Those amounts can make it difficult for many people to pay medical bills until the deductible is reached.

The impact of the closing on Calhoun County’s 6,600 residents may be profound. According to county health rankings produced by the University of Wisconsin, the county’s health outcomes already are ranked 154th in Georgia, ahead of only Terrell and Talbot counties.

Whiteley said with the closing, it may take residents 45 minutes to drive to the nearest hospital. The effect will be dramatic, especially for those needing emergency care, he said. “The golden hour is lost to many patients.’’

(The “golden hour’’ is the time in which the lives of many critically injured patients can still be saved if full-scale hospital treatment, such as surgery, is provided.)

The economic impact on Arlington and Calhoun County will be profound, with up to 100 employees losing jobs. A handful of other rural hospitals in the state also may be teetering on the brink, with rising levels of uninsured patients. HomeTown Health, an organization of rural hospitals in Georgia, says a half-dozen facilities could follow Calhoun Memorial’s move and shut down in the coming months. http://www.georgiahealthnews.com/2013/02/small-rural-hospital-closes-d
oors-follow/#sthash.FoPzMCaS.dpuf
]


These closings are more than just minor inconveniences to those who live in these communities; real lives are being put in danger. This of course, hasn’t fazed many red state governors.

Many of the governors who are refusing Medicaid expansion claim to be “pro-life,” but their actions will undoubtedly directly result in untimely deaths. A young woman in Georgia was immersed in flames after a four-wheeler accident. At one point, there had been a hospital only nine miles from the accident. Due to GA Governor Nathan Deal refusing Medicaid expansion, however, that hospital had been closed down only weeks earlier. So what happened to this poor young lady, suffering from second- and third-degree burns? It took a full two hours before she was flown to a hospital in Florida. ( http://www.bloomberg.com/news/2013-11-25/obamacare-cutbacks-shut-hospi
tals-where-medicaid-went-unexpanded.html
)

Other rural hospital closures are occurring solely because governors have refused Medicaid. The federal payments from the Disproportionate Share Hospital Program (DSH), which provided funding to many rural hospitals, has been pulled because the Medicaid expansion was slated to keep their funding flowing.

When states refuse the ACA Medicaid expansion, they’re not only turning down money to help their citizens, they’re literally giving away money that they already receive through the DSH program. No matter how you look at it, it’s a lose-lose situation. Citizens in rural areas with closed hospitals are now having to drive up to 50 miles for emergency medical care. This commute, along with a lack of health insurance, is expected to cause 27,000 deaths next year alone ( http://www.huffingtonpost.com/ethan-rome/27000-may-die-next-year-b_b_4
473163.html
).

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