Rural hospitals have been closing at alarming rates, no longer able to bring in enough revenue to serve their communities. Fortunately, there is something both state and federal legislators can do to keep local hospitals open.
State governments: if you haven’t expanded Medicaid, do it now. Under the Affordable Care Act, most of the cost of that expansion will be borne by the federal government. If you don’t expand, then don’t be surprised if your constituents blame you when their local hospitals close. Without Medicaid to cover people’s expenses, hospitals lose money caring for uninsured patients who can’t pay their bills.
The federal government: Congress needs to provide financial help to hospitals that serve large uninsured populations. That’s not an unrealistic expectation. The federal government used to provide such assistance, called DSH (or “dish” payments), but those payments were phased out with the passage of the Affordable Care Act, under the (now false) assumption that every state would expand Medicaid and, thus, there wouldn’t be many uninsured patients.
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