Already troubled, rural hospitals brace for effects of Obamacare repeal

When she walks through the halls, she recognizes faces by the community along with even by her days working as a school teacher. The 64-bed facility, she says, can be a mainstay of This kind of rural Southwest Pennsylvania town.

“This kind of hospital all my life has been here,” said Keller, today retired. “[that will] helps a lot of people who don’t have adequate health care coverage — along with I don’t know what they would certainly do without that will.”

Aside by providing health care to a largely poor population, that will provides hundreds of jobs in a town that will locals say never recovered after industries such as coal mining along with glass manufacturing disappeared.

however within the wake of This kind of fall’s presidential election, Highlands — like many some other rural hospitals — will likely face fresh financial challenges that will will intensify longstanding struggles, experts say.

The Affordable Care Act, which President-elect Donald Trump has vowed to repeal, threw several life-savers to these vital however financially troubled centers. along with its full repeal, without a comparable along with viable replacement, could signal their death knell.

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Highlands provides one window into how some of these shifts could reverberate in smaller towns across the country. along with ironically, 64 percent of people here in Fayette County — one of the state’s poorest — voted for Trump. Pennsylvania, which has the third largest rural population within the nation, played a pivotal role in his upset victory This kind of fall.

The health care law expanded Medicaid to tens of thousands of previously uninsured patients, providing fresh revenue streams for rural hospitals, which often serve a poorer, sicker patient population. The law also created a program that will allowed some of these facilities to buy prescription drugs at a discount, though Highlands qualified for that will program independently of Obamacare.

“All these rural hospitals are operating on thin margins. The removal of any income source or coverage, or expansion of bad debt, can be going to create significant financial hardship,” said Alan Morgan, CEO of the National Rural Health Association.

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Rural hospitals have long operated on the edge. within the past six years, more than 70 such facilities have closed, citing financial duress. Almost 700 more have been deemed at risk of following the same path.
Meanwhile, the need for reliable health care remains pressing. Conditions such as heart along with lung disease (PDF) are widespread in rural areas. Addiction to the prescription painkillers known as opioids can be acute. Nationally, the Medicaid expansion offered a bit of stability for some rural hospitals at risk of closure.
Researchers say that will disproportionately benefited such facilities — particularly here along with some other states with large rural populations, such as Illinois, Kentucky along with Michigan.
In Pennsylvania, 625,000 people enrolled within the expanded Medicaid program. Close to 300,000 came by rural areas, said Andy Carter, president of the Hospital along with Health System Association of Pennsylvania.

As of October, about 42,700 of Fayette’s residents had Medicaid, according to state data, an increase of about 8 percent by 39,460 in June 2015. (Pennsylvania’s Medicaid expansion took effect in January of that will year.) that will’s close to one-third of the county’s population.

Despite that will, Highlands CFO Andursky said he barely noticed the increase — the threat of closure can be a “daily concern,” he said. “that will seems like you’re taking two steps forward, three steps back,” Andursky said. “that will’s not like I can look to 5 years out — because I have to worry about tomorrow. I can’t worry about next year.”

John Andursky, CFO of rural Highlands Hospital, says that will producing ends meet can be a daily struggle.

that will pessimism can be heard throughout This kind of town of about 7,0 residents. While the law was described as historic, many here do not perceive that will that will helped them. Like many some other states, Pennsylvania re-branded their expanded offering of federal insurance program for the poor, fearing that will “Medicaid” which can be also often referred to as “Medical Assistance” would certainly be off-putting; today that will can be called “Healthy PA.”

Bryan McMullin, a 47-year-old who works in Connellsville’s river-rafting business, got coverage last year however said not bad health care remains hard to come by. “In This kind of area, nothing’s changed in 40 years, no matter who can be president,” he explained by a barstool at a pub near the today-vacant glass factory.

Daniel Martin, a 28-year-old Highlands patient who also works within the rafting trade said he uses his fresh coverage for his monthly blood medication. A Trump voter, he hadn’t realized that will coverage today could be in jeopardy.

along with smaller towns like This kind of tend to be far sicker than the norm. In Fayette, more than 1 in 10 people can be estimated to have diabetes. Out of 67 counties within the state, Fayette ranks 66th for health outcomes along with more than a third of its residents are obese.

that will’s tied with northern Potter County for the second-highest teen birth rate within the state. Between 2014 along with 2015, the county saw about 31 people overdose for every 100,000, according to an analysis by the federal Drug Enforcement Administration (PDF).
Plus, the hospital can be Connellsville’s second-largest single employer (PDF), after the school district. that will contributes an estimated $15 million to the local economy, Andursky said. that will’s in a town where unemployment’s already at 7.6 percent — up by last year along with higher than the state along with national averages.

“When I was a kid, everybody had a job, everybody had health care. today, look at the statistics,” said McMullin, one of the rafters.

There are some other hospitals within the region.

With 64 beds, Highlands Hospital can be a crucial economic engine along having a key source of local health care.

Uniontown, about 15 miles away, can be also in Fayette County. that will has 175 beds — more than double Highlands — however no behavioral health services to treat problems like addiction. Frick, another smaller rural hospital about 12 miles away, technically serves neighboring Westmoreland County. For more serious conditions, along with trauma care, university hospitals are about an hour away — in Pittsburgh on one end, along with Morgantown, West Virginia, on the some other. Patients in extremis often get stabilized at the local hospitals before transfer.

however rain along with snow, combined with mountainous terrain along with limited public transit, mean traveling even short distances poses hardship. “that will can be still challenging to have to travel even 20 miles to get your care,” said Lisa Davis, director of Pennsylvania’s Office of Rural Health along with outreach associate professor of health policy along with administration at Pennsylvania State University. “that will could take you all day to get to a one-hour appointment.”

In a medical emergency, getting care quickly can mean the difference between life along with death

So far, the incoming Trump administration hasn’t released its health plan to replace Obamacare. however, experts say, that will can be likely to give the states less federal money for treating the poor. that will can be unclear how rural hospitals will compensate for the financial benefits they are likely to lose — or how many more rural hospitals will fall.

“What they need to do can be be sure to protect the government programs: Medicare along with Medical Assistance,” Andursky said. “We can’t put them at risk.”

Already troubled, rural hospitals brace for effects of Obamacare repeal

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