Obamacare Hits Rural Communities Hard

You might say rural hospitals in America have a tough row to hoe.

Low population density means there is less aggregate demand for medical services and the lack of Panera locations means it’s tough to attract doctors and nurses when all you have to offer is gas station coffee.

And a serious medical emergency out in the country means the patient is in serious trouble.

As a recent story in the Washington Post found rural hospitals are in a bind caused by factors that aren’t found in most urban areas: “declining populations; disproportionate numbers of elderly and uninsured patients; the frequent need to pay doctors better than top dollar to get them to work in the hinterlands; the cost of expensive equipment that is necessary but frequently underused; the inability to provide lucrative specialty services and treatments; and an emphasis on emergency and urgent care, chronic money-losers.”

Now rural hospitals are facing a new threat that may hasten the closure of medical facilities all across the nation. And that threat is a familiar one: Obamacare.

The Post analysis found “declining federal reimbursements for hospitals under the Affordable Care Act as the principal reasons for the recent closures. Besides cutting back on Medicare, the law reduced payments to hospitals for the uninsured, a decision based on the assumption that states would expand their Medicaid programs. However, almost two dozen states have refused to do so.”

The National Rural Health Association, a group composed of 2,000 small hospitals and other rural medical professionals, notes with some alarm that 48 country hospitals have chained the gurney to the wall for the last time since 2010. Another 283 hospitals are on life support, so to speak. And Texas, which combines low rural population with large amounts of empty prairie, has had the most closures with a total of 10.

In Mount Vernon, Texas (population 2,678), located almost midway between Dallas and Texarkana, Post reporters found Dr. Jean Latortue is attempting to replace the closed local hospital with an outpatient and urgent care facility. What’s more, he is doing it at his own expense.

But Dr. Latortue is the outstanding exception to the rule in other country towns.
For the rest of rural America many are finding that contrary to promises under Obamacare they can’t keep their doctor, they can’t keep their insurance and many can’t even keep their hospital.