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Trumpcare Would Crush Rural Hospitals & Families

by Cameron Norsworthy

For rural families in particular, U.S. health care policy is lacking. Though the Affordable Care Act (ACA) offered some solutions, it's by no means sufficient in practice. A proposed alternative should work to meet the needs of rural families a bit better. That's why what Trumpcare would do to rural hospitals, according to a report released by Democrats on the Joint Economic Committee and the Senate Special Committee on Aging, is so troubling.

In short, the report, called "TrumpCare Threatens Rural Hospitals," claims that President Trump and the GOP's American Health Care Act (AHCA) would likely threaten rural hospitals, local economies, and the older Americans citizens. "TrumpCare, which will cut $834 billion over 10 years from Medicaid and undermine the private health insurance market in rural areas by cutting premium assistance, will hurt rural hospitals, [which] will face even more difficulty recruiting and retaining health care providers; maintaining hospital day-to-day operations; and supporting their communities’ health needs," the report states. "Rural hospitals are also economic engines in smaller communities, and when they are at-risk so too are the jobs and economic growth they provide in rural areas."

Numbers don't lie: Rural hospitals are closing at an alarming rate. Though the ACA lowered the uninsured rate by nearly 9 percent, many Americans who earn too much to qualify to Medicaid have still not been able to find affordable coverage, Stat News reported. Thus, uninsured patients are still being treated by hospitals that, in the end, suffer large monetary losses. This shortcoming, conflated with other structural issues (including "a nationwide trend toward outpatient care, trouble recruiting staff, industry consolidation, low-patient volume, and a preference by private-insurance clients for newer hospital," Stat explained), is putting rural hospitals in a tough spot. But is Trumpcare the answer to a broken system?

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Legislation is rarely — if ever — perfect, and you might guess that Trump's AHCA is no exception. Many analysts agree that the AHCA will fail rural families to a greater degree than its predecessor has, in part because, when uninsured rates increase and Medicaid funds are cut, as the report states, hospitals will have to bear the burden, causing the aforementioned cycle of inadequate resources to persist.

Speaking for the National Rural Health Association, Maggie Elehwany summarized the health care concerns of rural families to NPR, saying: "We want to make sure that they understand that the well intentions of the ACA have really fallen short and may actually be exacerbating the hospital-closure crisis." Hospital closings don't just affect health care resources, Elehwany asserted, but they can wreck a community's entire economy; A lack of necessary facilities lowers property values, which discourages new business, hurting families twice over.

"First, [Trumpcare] rips health care protections away from millions," Sen. Bob Casey of Pennsylvania, Ranking Member of the Senate Special Committee on Aging, explains in an email. "Then, it threatens health care jobs in hundreds hospitals and clinics by eliminating vital funding." According to the report, health care and social services sectors in rural counties employ 17 percent of workers; Dissolving these jobs would spell disaster.

The chief lobbyist of the largest association of physicians, Richard Deem of the American Medical Association (AMA), shared that the group opposes the AHCA. AMA President President Andrew W. Gurman explained that, though the ACA has its faults, the AMA "continue[s] to support the goal of making healthcare more affordable and accessible for everyone and better protecting patients from the devastating financial costs that can result from a health emergency or a serious illness" — goals that, by this recent report's estimation, can't be met under the AHCA.

Democratic lawmakers are concerned about the impact the AHCA would have on the communities that they represent, especially where Medicaid funding is concerned. "Instead of tearing communities down through a disastrous health care bill," says Sen. Martin Heinrich of New Mexico, Ranking Member of the Joint Economic Committee, "we should be working together to ensure that our economy works for everyone, and that Americans across this country, regardless of where they live, have a fair shot at getting ahead.”

As it stands, the AHCA leaves rural families and hospitals behind. The policies presented not only eliminate jobs, but they also endanger the wellbeing of rural Americans. Many lawmakers are looking for transparency and discussion, considering the heavy impact that this legislation will have. But, the health care bill's secrecy isn't doing anyone any favors, especially for rural groups who will be affected by it the most.