Confederate crusade is closing hospitals in rural America, September 15, 2014

The cost of the Confederate conservative ideological crusade against the Affordable Care Act is taking a human and economic toll. In states that refused to participate in Medicaid expansion, many rural communities soon find their local emergency rooms shuttered.

“Nearly half of states are so locked into the politics of Obamacare that they’re willing to leave nearly 5.7 million of their own people uninsured,” said a statement on the White House website.

Across the country, many rural hospitals are closing down, according to the National Rural Health Association, which reported that 14 rural hospitals shut down last year alone, leaving whole communities without rapid access to emergency care.

That’s not just a health care problem; it is an economic issue too. In addition to health services, research shows hospitals contribute significantly to local economies.

They bring outside dollars into rural communities and stimulate local purchasing power while they help attract industry and, in some locales, a steady flow of retirees.

The increasing rate of hospital closures in rural America is alarming but the cure is simply a matter of increasing the number of insured patients, which can be traced to obstinate Republican governors who refuse to participate in Medicaid expansion and congressional gridlock in Washington, D.C.

The problem of hospital closures requires a political solution that appears beyond America’s capacity to achieve, since most observers are predicting a Republican victory in November that could hamstring efforts to save lives.

President Obama’s Affordable Care Act (ACA) provided for millions of uninsured Americans to gain coverage through expanded Medicaid programs but more than 20 states governed by Republicans have opted to turn down millions of dollars annually in federal funds.

States that don’t expand Medicaid will miss out on a total of $88 billion through 2016, according to a July 2 report from the White House Council of Economic Advisers.

North Carolina Governor Pat McCrory’s refusal to expand Medicaid was made possible by a Supreme Court ruling that gave states the option to opt out.

The ACA allows states to expand their Medicaid programs to anyone whose income is below 138 percent of the federal poverty level, which is currently just over $15,000 for a single person.

Despite the federal government offering to cover the cost of newly eligible enrollees through 2016 (and 90 percent of their costs thereafter), Republican governors such as McCrory argue that expansion would be too costly for their states in the long run.

States’ decisions to opt out of the expansion have put tremendous pressure on rural hospitals, said Christopher Coleman of the Tennessee Justice Center. In his home state, 28 rural hospitals face major budget cuts or closure. Many have already cut down on services and significantly reduced staff.

In Georgia, which also is not expanding Medicaid, four of its 65 rural hospitals have shut down over the past two years. As many as 15 more may be closing due to shrinking budgets and razor-thin government reimbursements, according to Hometown Health, a trade association that represents 56 hospitals in rural Georgia.

In Alabama, six rural hospitals have closed in the past 18 months and 22 more are facing serious financial shortfalls. Meanwhile, the state’s Republican governor, Robert Bentley, continues to reject the expansion of Medicaid.

Most of the ones that refuse to accept Obama’s prescription to save lives and have not proposed an alternate model for expanding insurance coverage for low-income residents were once Confederate slave-holding states: South Carolina, Mississippi, Florida, Alabama, Georgia, Louisiana, Virginia, Tennessee, Missouri, Kentucky, North Carolina and Texas.

States that rejected Obamacare lost funding for uninsured patients who show up at emergency rooms for treatment that they cannot pay for and hospitals that treat large numbers of them are closing.


New Jersey, New Mexico, Ohio, Michigan, Nevada, Iowa, Arizona and Pennsylvania joined the ranks of those expanding Medicaid despite having Republican governors because the Confederate jihad against Obamacare is not conservative leadership, it is merely a crazy way to kill Americans.

While the election in November offers voters a chance to end this madness, pollsters predict a GOP victory that could propel the nation into an even worse situation. Such self-inflicted injuries would be a terrible condemnation of democracy.

More News