Already in peril, rural hospitals are unsure on health care bill
CLAXTON — Talmadge Yarbrough had just sat down at his desk and opened a box of pecans when he let out a gasp that could have been his last breath. He’d gone into cardiac arrest in his office, a co-worker called 911, and an ambulance drove him two miles to the small hospital that serves this rural community in southeast Georgia.
“I would have never lasted to get to Savannah or Statesboro,” Yarbrough said of the biggest cities near Claxton — each 30 to 60 miles away. “I firmly believe if that hospital wasn’t here, I wouldn’t be here.”
But like Yarbrough, the 10-bed Evans Memorial Hospital has fought to survive. That story is reflected nationwide — rural hospitals have long struggled, with patients who are older, suffer from chronic illnesses, and face few insurance options, if they’re insured at all. Most rural hospitals have a higher-than-normal percentage of Medicaid patients; expected cuts to the federal program for low-income residents will affect facilities everywhere, but experts and administrators are particularly worried about rural areas. Still more rural patients are on Medicare, for those 65 and older, but both programs’ reimbursements are lower than the cost of care.
Now, as Republicans in Washington put forward long-anticipated plans to get rid of President Barack Obama’s Affordable Care Act, rural hospitals and communities are watching the debate closely. But if they didn’t fare too well under the ACA, many question whether they’d be better off under the plan backed by President Donald Trump.
At Evans Memorial, many blue-collar workers are unable to afford insurance but are too well-off for Medicaid, said chief financial officer John Wiggins. Such uninsured patients are perhaps the No. 1 problem for rural hospitals: Evans Memorial has been saddled with $3 million or more in unpaid medical bills in recent years.
But the hospital can’t and won’t turn away the uninsured — federal law prohibits it in emergencies. Recently, Dr. Kyle Parks performed an urgent gallbladder operation on an uninsured woman. “It is what we’ve always done — we take care of people, payer or no payer,” Parks said. “But we’re fighting a struggle to keep our little hospital open.”