Starting this week, Mayor Adam O’Neal of Belhaven began leading his second 283 mile walk from his small town in North Carolina to Washington DC. This year, several state health care advocates we know and admire including Laura Guerra-Cardus of the Children’s Defense Fund Texas, five other Texans and repeat walkers Adam Linker and Nicole Dozier of the North Carolina Justice Center’s Health Access Coalition joined the crusade.
The closing of his local rural hospital prompted Mayor O’Neal’s first walk and this year he broadened his focus to all communities with rural hospitals in danger of closing. [I wrote about the Mayor’s first walk and the important issue that prompted it here.] Mayor O’Neal and his fellow walkers realize there are multiple reasons for rural hospital closures and the difficult path to maintain and even reopen health care facilities. But a major concern for many communities struggling to keep rural hospitals open is whether or not their state has accepted more federal Medicaid funding to reduce the number of uninsured people.
Numbers and research make the scope of this problem clear. The University of North Carolina’s Rural Health Research Program keeps an updated map of rural hospital closures across the county – and there are many. The Program also provides in-depth analysis of issues facing rural hospitals in all states.
The Kaiser Family Foundation recently released a study of a major nonprofit hospital system that operates 131 hospitals across the country. A spectacular finding was that charity care costs in states that expanded Medicaid had decreased 40% compared to a 6% decrease in non-expansion states. Just that one statistic makes abundantly clear the help for the bottom line of a health care facility working in a rural area where a high percentage of people would qualify under an expanded Medicaid program.
And a recent Deloitte analysis of Kentucky’s Medicaid expansion included the fact that there has been a $1.15 billion decrease in uncompensated are charges in both rural and urban hospitals since the implementation of Medicaid expansion in that state:
Mayor O’Neal’s walk ends June 15 in Washington DC with a rally in the Capitol but the issues his walk seeks to highlight will continue to push states to consider accepting the federal Medicaid funding to extend coverage to their lowest income residents. Policy research can provide numbers and reports that impact the decisions our elected leaders make for communities and families. However, O’Neal’s walk is so compelling to so many people precisely because it isn’t just about numbers – it’s about taking concrete action to bring attention to an issue deeply relevant in many rural communities. The financial data around Medicaid expansion and hospitals provides a way forward for rural hospitals. Mayor O’Neal is eager to take that road.
The participants will post regular updates on the texaswellandhealthy.tumblr.com blog and on Twitter at @TXWellHealthy. Additional information about the walk is available at thewalknctodc.com.
