Raleigh – On Monday, Vidant Health announced it would layoff nearly 200 employees after financial troubles and a tight budget. Just days earlier, Republican Governor of Oklahoma Kevin Stitt announced a plan to expand Medicaid, making Oklahoma the 38th state to work towards expanding or to expand Medicaid and leaving North Carolina one of just 12 holdouts. 

As hospitals shutter workers and Republican-led states expand access to health care, North Carolina Republicans hold out looks even more partisan and damaging by the day. 

Researchers at the University of North Carolina found that 120 rural hospitals have closed across the country since 2010 and, today, 453 of the 1,844 rural hospitals operating are considered vulnerable for closure. 

Study after study has proven that expanding Medicaid improves lives, particularly in southern states; and numerous reports have found that expanding Medicaid would not only benefit every county in North Carolina but reduce the chances of a rural hospital closing by 62 percent. Rural leaders, including leaders in Waynesville, NC, and leaders of local health care systems continue to call on the General Assembly to expand Medicaid.

As yet another Republican governor expands Medicaid and a major hospital system faces budget shortfalls, why are North Carolina Republicans still blocking all attempts at compromise that would create more than 37,000 new jobs, help rural hospitals, and insure more than half a million more people?

“North Carolina Republicans continue to have their head in the sand in a desperate power play to try and defend their feeble majorities in the General Assembly,” said Executive Director of the North Carolina Democratic Party, Meredith Cuomo. “If the recent elections in Virginia and across the country are any indication, betting against Medicaid expansion is a mistake.”

N&O: Vidant Health announces nearly 200 layoffs after financial troubles and tight budget
By Aaron Sánchez-Guerra
March 9, 2020 

• Vidant Health announced Monday that it will lay off 191 employees across its network to cut costs after revenues decreased in the first quarter of fiscal year 2020.

• The 1,708-bed health system faced an $18 million budget deficit during the first quarter of the 2020 fiscal year, according to a report from WITN in Greenville.

• The company said the decision comes from “a careful and objective assessment” seeking to reduce costs, increase efficiency in operations and discontinuing recruitment and hiring for certain non-patient care positions.

• “Making decisions that impact even one team member’s life is very difficult. We deeply value the contributions made by every team member. We are ensuring those impacted are supported by providing severance and comprehensive career counseling services,” Waldrum said in a statement. “This is not something we take lightly, and we will treat all impacted team members with respect.”

Forbes: Red State Oklahoma Closer To Medicaid Expansion
By Bruce Japsen
March 9, 2020

• Oklahoma is inching closer to expanding Medicaid coverage to tens of thousands of residents under a plan to be submitted to the federal government.

• The move by Republican Gov. Kevin Stitt comes as supporters of Medicaid expansion forge ahead with a campaign to put a ballot measure before Oklahoma voters in November. Stitt’s plan is being submitted to the Centers for Medicare & Medicaid Services, which would have to grant Oklahoma a waiver.

• Oklahoma has been one of 14 remaining holdout states that have already missed out on generous federal funding of the Medicaid expansion. From 2014 through 2016, the ACA’s Medicaid expansion population was funded 100% with federal dollars. The federal government still picks up 90% or more of Medicaid expansion through 2020. It’s a better deal than before the ACA, when Medicaid programs were funded via a much less generous split between state and federal tax dollars.

• Such expansion has been a boon to doctors, hospitals and health insurers like Anthem, Centene, UnitedHealth Group and CVS Health’s Aetna health insurance unit given these private insurers generally administer most Medicaid benefits in the U.S. Expansion could bring coverage and new revenue to healthcare companies as soon as 2021, analysts say.

Vox: 1 in 4 rural hospitals is vulnerable to closure, a new report finds 
By Dylan Scott
February 18, 2020

• Since 2010, 120 rural hospitals have closed, according to University of North Carolina researchers. And today, 453 of the 1,844 rural hospitals still operating across the country should be considered vulnerable for closure.

• According to [the Chartis Center for Rural Health], being in a Medicaid expansion state decreases by 62 percent the likelihood of a rural hospital closing. Conversely, being in a non-expansion state makes it more likely a rural hospital will close.

• Nevertheless, here is how the Kaiser Family Foundation summarized the available research:
  • • Studies demonstrate that Medicaid expansion has significantly improved hospital operating margins and financial performance. A study published in January 2018 found that Medicaid expansion was associated with improved hospital financial performance and significant reductions in the probability of hospital closure, especially in rural areas and areas with higher pre-ACA uninsured rates.
  • Another analysis found that expansion’s effects on margins were strongest for small hospitals, for-profit and non-federal-government-operated hospitals, and hospitals located in non-metropolitan areas. A third study found larger expansion-related improvements in operating margins for public (compared to nonprofit or for-profit) hospitals and rural (compared to nonrural) hospitals.

• States had a choice about expanding Medicaid, and so far, 14 states have rejected the offer. They’ve left 2.3 million people uninsured. And they are putting the future of their rural hospitals at risk.