Raleigh – The leaders of Waynesville, NC voted unanimously to lend their voice to “a chorus” of rural leaders calling on members of the General Assembly to expand Medicaid and protect rural hospitals “in hopes of moving the needle in Raleigh.” 

Days before Waynesville leaders took a “symbolic stand,” researchers at the University of North Carolina, as covered by Vox, found that 120 rural hospitals have closed across the country since 2010. Today, 453 of the 1,844 rural hospitals operating are considered vulnerable for closure.

Rural hospital leaders continue to single out the Republican legislature for standing in the way of progress. “There’s patients who are behind this and we are getting caught up in politics instead of taking care of people,” Rod Harkleroad, the CEO of Haywood Regional Medical Center, said.

Numerous research 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. Despite calls from rural leaders and leaders of local health care systems, Republicans in the General Assembly continue to ignore those requests and make politically motivated decisions rather than making important progress for their constituents. 

“We elect our representatives to serve our best interests and by ignoring local leaders and all of the evidence for Medicaid expansion, Republicans are hurting North Carolinians,” North Carolina Executive Director, Meredith Cuomo. “If they aren’t fighting for us, we’re going to vote them out.”


The Mountaineer: Waynesville takes symbolic stand in Medicaid expansion
By Becky Johnson 
February 20, 2020

• Waynesville leaders are calling on state legislators to expand Medicaid, joining a chorus of local governments across the state in hopes of moving the needle in Raleigh.

• Republican lawmakers who have resisted Medicaid expansion claim it would cost too much. But the irony is that failing to expand Medicaid has actually cost the state more, according to those who spoke at the hearing.

• [Rod Harkleroad, the CEO of Haywood Regional Medical Center] has visited with numerous legislators over the past two years to explain how not expanding Medicaid is hurting smaller community hospitals.

• The federal government picks up 90 percent of the cost for states to expand Medicaid. The 10 percent North Carolina would have to pick up is cited as a deal breaker by the Republican lawmakers blocking it.

• “The best way to save health care dollars is to keep people healthy. So we want them to go to the doctor before they are in crisis mode,” said N.C. Rep. Joe Sam Queen, D-Waynesville. “It is proven this saves money.”

• Since the majority of Medicaid expansion costs are paid by the federal government, North Carolina taxpayers are footing the bill for Medicaid expansion in other states but not getting their piece of the pie.

• Adding insult to injury, hospitals in states that haven’t expanded Medicaid have been penalized by lower reimbursement rates. The passage of Obamacare had been predicated on states expanding Medicaid. In exchange for picking up the tab for Medicaid expansion, the federal government lowered the reimbursements hospitals get for Medicaid patients.

• “It’s time the citizens understand what’s at stake and make their case to elected officials to do the will of the people,” Queen said.

• The idea for a town resolution endorsing Medicaid expansion came from Waynesville Alderman Jon Feicther. Feichter saw the issue of Medicaid expansion as “inextricably linked” to another issue the town is currently grappling with: how to fix a growing homeless population. “The lack of health insurance by so many in our state contributes significantly to homelessness in our community,” Feichter said.

Vox: 1 in 4 rural hospitals is vulnerable to closure, a new report finds 
By Dylan Scott
Feb 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.