Tyler Sherman, who works as a nurse in a rural hospital in Nebraska, is accustomed to the farmers in the area, many of them older adults, frequently visit the emergency room.
Now that Congress will cut around a billion dollars to Medicaid over 10 years, Sherman fears that these patients and the more than 3,000 webster county residents can lose not only access to emergency services, but also to the clinic and residence of older adults that their hospital has.
“Our budget depends largely on Medicaid reimbursements, so if a cut is produced, it will be difficult to keep the doors open,” said the nurse, who works at the webster county hospital in Nebraska, in the north of the border with Kansas.
If these facilities close, many will lose the opportunity to arrive at the Webster County Hospital in five minutes, and their journey will become a one -hour trip to the nearest health center, which offers the same services.
“It’s a long way to go when you have a medical emergency,” Sherman said. “Some will not survive.”
One hour from the nearest hospital
Several states and groups that defend access to health warn that the cuts to Medicaid – a program that serves millions of low -income Americans and people with disabilities – will hit the already fragile rural hospitals and will force hundreds of them to close, leaving some people in remote areas without nearby urgent medical care.
More than 300 hospitals are at risk of closing after approval in the Republican Fiscal Law Congress, according to an analysis of the Cecil G. Sheps Center of the University of North Carolina in Chapel Hill.
A health clinic in the town of Curtis, in southwest Nebraska, announced on Wednesday that it will close in the coming months, blaming in part to the planned cuts of Medicaid.
Bruce Shay, who lives in Pomfret, Connecticut, fears that he and his wife are some of those who are left without attention. At 70, both enjoy good health. But that means that, if either needs to go to a hospital, “it will be urgent.”
The Day Kimball hospital is close, in Putnam, but has faced financial problems recently. The general director of Day Kimball, R. Kyle Kramer, acknowledged that the Senate bill approved on Thursday – which is estimated to cut the federal medicality expense in rural areas at 155,000 million dollars within 10 years – would further harm his hospital.
Approximately 30% of the current patients of the Kimball Day receive benefits from Medicaid, a figure that is even higher for specific and critical services such as obstetrics and behavioral health.
“In case of urgency, I am between 45 minutes and one hour from the nearest hospital, and that is a problem,” Shay said. And he and his wife would not be the only ones who would have to make that trip.
“There, I am sure, thousands of people who depend on the Day Kimball Hospital. If you close, thousands of people would have to go to another health center,” Shay said. “It is a huge burden to suddenly impose on a hospital system that is already on the limit.”
Hundreds of hospitals would close
Rural hospitals have been working for a long time to the limit of their financial possibilities, especially in recent years, when Medicaid payments have continually fallen below the real cost of healthcare. More than 20% of Americans live in rural areas, where Medicaid covers 1 in 4 adults, according to the non -profit organization KFF.
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The bill of tax cuts and expenses by value of 4.5 billion dollars signed this Friday, Donald Trump, would worsen the difficulties of rural hospitals by cutting a key federal program that helps states to finance medical payments to medical care providers.
To help compensate for the loss of fiscal income, the package includes 1.2 billion dollars in cuts to Medicaid and other social security network programs, which the administration insists that they only eradicate fraud and waste in the system.
But public protests for Medicaid cuts led the Republicans to include a disposition that will allocate $ 10,000 million annually to reinforce rural hospitals over the next five years, or 50,000 million dollars in total. Many defenders of rural hospitals fear that it is not enough to cover the deficit.
Carrie Cochran-McClain, director of policies of the National Association of Rural Health, indicated that rural hospitals are already working to achieve a balance, citing a recent report by the American hospitals association that found that hospitals in 2023 obtained almost 28,000 million dollars less of a doctor than the real cost of treating Medicaid patients.
“We see that rural hospitals from all over the country really operate with negative or very small operating margins,” said Cochran-McClain. “Which means that any cuts to a payer – especially one like Medicaid, which constitutes a significant part of the financing of rural suppliers – will have consequences for the ability of rural hospitals to provide certain services or even maintain their open doors.”
Kentucky, the most beaten state
A KFF report found that 36 states will lose 1,000 million dollars or more in 10 years in medical financing for rural areas with the Republican bill, even with the rural fund of 50,000 million. No state will lose more than Kentucky.
The report estimates that the State would lose 12.3 billion dollars, almost 5,000 million more than the next state of the list. This is because the bill puts an end to the single Kentucky Medicaid refund system and reduces it to Medicare’s refund levels.
Kentucky currently has one of the lowest Medicare refund rates in the country. It also has one of the highest poverty rates, which makes a third of its population covered by Medicaid.
The governor of Kentucky, Andy Beshear, a Democrat who carries two mandates and is considered a possible candidate for the presidency in 2028, said that the bill would close 35 hospitals in his state and withdraw the health coverage of 200,000 residents.
“Half of Kentucky’s children are covered by Medicaid. They will lose their coverage and will pass work to get the next recipe,” Beshear said during an interview with the MSNBC news chain. “This will negatively affect the lives of each and every one of the Americans. It will hit our economy.”
