Medicaid is a critical safety net for rural hospitals, providing stability to ensure patients in less populated and remote areas can get the care they need. Funding cuts to Medicaid passed in the One Big Beautiful Bill Act (OBBB) put rural hospitals at risk of having to cut vital services or even closing entirely.
Washington state’s 44 rural hospitals and the patients they serve will soon feel the impact. An estimated 350,000 Medicaid enrollees in Washington are estimated to lose their Medicaid coverage, threatening patients’ access to care and increasing uncompensated care, which will further strain hospitals and providers. Rural hospital leaders warn that these changes could cause lasting damage to local health care systems and families and communities.
Rural Hospitals on the Brink
In a recent piece from The Spokesman-Review, health system leaders expressed deep concern about how Medicaid cuts would affect the care they provide to patients every day:
- “Rural hospitals in Washington have spent the years since the COVID-19 pandemic on the brink as they care for patients who increasingly trend older, poorer and…beset with multiple medical conditions and therapy needs that make care more expensive…Many rural hospital leaders say changes to Medicaid eligibility and payments in the coming years will equate to cuts and do irreparable damage to rural healthcare.”
- “Columbia County Health System CEO Shane McGuire…[calls] the impact of cuts to Medicaid the ‘impending failure of rural healthcare…People may be forced to move from their community, or we may no longer be able to provide that long-term care service,’ McGuire said.”
- “McGuire says his hospital, Dayton General, is among several in Washington that could close…‘We have assisted living – 60% of those residents are Medicaid beneficiaries. And so while they’re not specifically targeted by the bill, if the state’s Medicaid system gets strained from lack of funding, they’re going to have to look at cuts everywhere.’”
- “‘We don’t have an urgent care clinic around here,’ said [Dayton General Hospital] emergency room nurse Grace Coulston. ‘We have our clinics, but they can’t get people in for same-day care. We are the first line of defense here in this town for anything and everything.’”
- “East Adams Rural Health CEO Corey Fedie said that…any reductions in Medicaid funding would ‘have an impact on all departments and cause concern for loss of patient care for our community. We believe members of our community will lose their coverage or be forced to move into less generous or higher-deductible plans,’ Fedie said. ‘This will impact their health and raise charity care costs at our hospital. Rural communities on average have a larger proportion of Medicaid enrollees, so we are likely to feel this more acutely,’ he said.”
“It would ruin our community”: Washington families brace for hospital closures
KUOW, Seattle’s NPR station, recently highlighted how Medicaid cuts jeopardize access to critical care for Washington families like the Severes, who have relied on their local rural hospital for various emergencies.
- “Their house is less than a mile from the Dayton General Hospital — so when Maddie lost consciousness, the ambulance was there within minutes. But when changes to the federal Medicaid program take effect in about a year, rural hospitals like Dayton General could face closures, leaving people to drive an hour or more to the next closest options.”
- “Rural hospitals depend more on Medicaid income than urban hospitals, and many are already operating on the brink…For the Severes, the next closest emergency room is in Walla Walla, 45 minutes away.”
- “‘The Severes said they’ve lost count of all their hospital visits, but estimate they’ve been dozens of times. I have a lot of feelings about the possibility of losing our hospital,’ Elise Severe said. ‘It made me panic. It actually made me really mad…It would ruin our community.’”
- “If hospitals don’t have as many patients who can pay walking in the door, that won’t just affect people on Medicaid or those who’ve lost their health coverage. If hospitals have to shutter services or close their doors, it will affect everyone — including people like the Severes, who have health insurance through an employer.”
Policymakers must take steps to protect access to coverage and essential health care services for the patients and communities who rely on Medicaid. For more information on Medicaid’s vital role, visit https://modernmedicaid.org.