EDITORIAL NOTE: This guest blog post was written by Grace Chimene, legislative director of the League of Women Voters of Texas
Rural hospitals are in trouble in the United States. According to the National Rural Health Association, there are 283 rural hospitals in the U.S. that are financially stressed and may close in the next few years leaving communities without lifesaving health care services. Rural hospitals not only provide health care, they also provide jobs. Communities with rural hospitals may also be more alluring to businesses and families, including veterans and retirees.
Many rural hospitals were created by the Hill Burton Act of 1946 which was enacted to expand hospital systems into underserved areas. Now those same hospitals are in crisis. The Emergency Medical Treatment and Active Labor Act (EMTALA) requires emergency departments to provide emergency care for patients whether they are insured or not. Unsurprisingly, hospitals in states with high rates of uninsured are under more financial stress. Hospitals in the 16 states that haven't accepted Medicaid expansion, the federal funding provided by the Affordable Care Act (ACA) for states to expand their Medicaid programs in order to cover low-income Americans, are also especially stressed.
Hospitals, who put their finances ahead of their community’s health care needs, may believe that closing the hospital and opening a clinic is the answer. While clinics provide important and needed services, they do not provide the 24 hour emergency health care and other services that a hospital does and that a rural community requires. When a patient is experiencing a trauma, such as a stroke or heart attack, the rate of survival improves dramatically if health services are provided quickly, what is colloquially known as a “Golden Hour.” Helicopters and community clinics cannot replace the services provided by a rural community hospital. Without rural community hospitals to provide those emergency services, lives are lost.
As a pediatric nurse practitioner, I know first-hand the impact rural hospitals can have on a community. To bring attention to the support rural hospitals need, I decided to join an annual walk from North Carolina to Washington, D.C. I was joined on this year’s walk by my daughter, a future Texas A&M medical student. The 283-mile walk was launched last year by the mayor of Belhaven, NC and we began our walk in this small town where a hospital closed last year. We have then covered one mile for each rural hospital that is at risk of closing the U.S. in the next few years. This year, folks from 11 other states joined Belhaven Mayor Adam O’Neal and civil rights activist Bob Zellner. Local community supporters often join for a day or two as we traverse their community. Others honk and give us a thumbs-up to show their support. We even had the driver of an 18-wheeler pull over on the freeway to make a financial contribution!
We ended our walk at the steps of the U.S. Capitol. The courageous folks of Bellhaven, NC met us there. The walkers gave speeches at the rally. I shared a story from Texas of a toddler who died from choking on a grape because the local hospital her parents brought her to had closed just weeks before. Other speakers called for federal and state policy makers to fix the rural health care crisis, to prevent corporate hospitals from taking over and then closing rural hospitals, and to increase the numbers of insured citizens in rural communities by accepting the Medicaid expansion money provided by the ACA into their states.
I worked tirelessly during the past legislative session as the Child Health Issue Chair and Legislative Director for the League of Women Voters of Texas. I joined with the Cover Texas Now Coalition and Texas Well and Healthy to educate legislators on the importance of accepting federal Medicaid monies to help Texas families and the communities they live in. Unfortunately, the Texas legislators and Governor Abbot ignored the billions of ACA dollars that Texas communities need to keep their hospitals open. They ignored the health care crisis, took no action and presented no plan to do so in the future. So in my frustration, I joined The Walk as a new avenue to bring attention to this critical issue.
But there’s potentially some payoff from the long days, heat and blisters – the National Rural Hospital Association believes that in the next few weeks, a bill to ensure access to emergency care and allow hospitals to offer outpatient care for their community will be introduced in Congress. This would go a long way to serving these communities in need. But even if this bill is introduced and passed, to truly stop the crisis, states, like Texas, will need to expand Medicaid to support their rural and urban hospitals.
To see more of Grace's walk, visit her Tumblr: Our Walk to DC for TX Hospitals and Coverage.