Minnesota's rural health care landscape is described as being "stressed" — and the diagnosis could become grimmer if congressional Republicans keep their sights on Medicaid when reducing spending.
Specifics need to be sorted out, but the budget framework advanced by House Republicans this week is expected to include major cuts to Medicaid, so lawmakers can adopt President Donald Trump's tax-cut plan. Health care voices have said the government insurance program has a big presence in rural areas.
U.S. Sen. Tina Smith, D-MN, touched on that issue in a news conference hosted by Protect Our Care when discussing how Minnesotans would feel the pain.
"Many of the patients that show up for care at rural hospitals are folks that get their insurance either through Medicaid or through Medicare," she said. "It tends to be in rural communities; an older and often sicker group of people."
Smith added that losing reimbursements would force more rural providers to make tough decisions by doing away with services such as maternal care or pain management.
House Republicans have said they're eyeing a final plan that "makes government work more effectively for all Americans." But they're already seeing backlash in their home districts.
Mark Jones, executive director of the Minnesota Rural Health Association, said the situation in this state isn't as dire compared with other parts of the country. But he said deep Medicaid cuts would still overwhelm the landscape as providers in smaller towns try to stand upright.
"We've seen providers leave, we've seen services cut," he said. "We've made our way through the pandemic, and now one more struggle — much of which we have no control over or little control over."
Jones reminded people that Medicaid coverage isn't a handout. He said recipients in rural areas — who often are working — have little choice but to turn to programs such as these.
"The wages aren't there to support commercial health care," he said, "or employers are very small and can't offer a group plan."
If congressional Republicans go big on Medicaid cuts, with more than $800 billion currently projected, Jones said, Minnesota's list of rural hospital closures could grow longer. Six have shuttered since 2005, which he said hurts local economies and makes communities less attractive.
"If you're trying to recruit a teacher at the school, or you're trying to recruit somebody at the law office or the bank downtown, when they come to town to look at your community and you don't have a hospital," he said, "that's kind of a sign that your town isn't very healthy."
