The large finances invoice proposed by President Donald Trump and handed by the U.S. Home of Representatives final month will nearly definitely have a far-reaching and devastating impression on well being care entry in rural areas — areas like my residence of Okanogan County, the place I’m a doctor.
Every single day, Mid-Valley Hospital in Omak sees sufferers who’ve traveled 60 to 90 minutes to hunt pressing and emergency care, together with girls in labor. Monetary pressure has already brought about closure of obstetric providers in two of our three crucial entry hospitals — these with fewer than 25 beds — and we battle to keep up specialty care providers. Our major specialty care middle in Wenatchee is usually unable to just accept new sufferers, and in Yakima, the biggest metropolis within the area, just one hospital stays to serve greater than 100,000 individuals. Tribal communities just like the Yakama Nation and Colville Reservation face much more boundaries.
As a household medication doctor, I’ve delivered dozens of infants whose dad and mom raced down lengthy mountain highways, hoping and praying they may get to us in time. Sufferers should journey lengthy distances to an pressing care clinic for accidents, coronary heart assaults, strokes and different issues that in additional city areas could be handled in emergency departments.
I additionally function the general public well being officer for Okanogan County, the geographically largest county in Washington. Due to our dimension and topography, many residents already discover it exhausting to get high quality care. Including monetary burden to those boundaries will solely worsen affected person outcomes.
Okanogan County is closely depending on Medicaid and Apple Well being. Two-thirds of newborns I ship at Mid-Valley Hospital are billed to Medicaid. As of 2023, 42% of all children within the county acquired insurance coverage by means of that program.
That is emblematic of Central Washington. The 4th Congressional District that U.S. Rep. Dan Newhouse represents is essentially the most Medicaid-dependent district within the state, with nearly 300,000 district residents enrolled. That’s why it was heartbreaking to see the U.S. Home go their finances invoice final month, and to see Rep. Newhouse vote for it.
If this invoice had been to turn out to be regulation with none adjustments, it should injury rural communities throughout the nation. It’s sure that some hospitals, clinics and long-term care amenities, already stretched skinny within the present system, will shut. A study launched final week confirmed that 14 rural hospitals throughout Washington are in peril of closure, together with many in Central Washington, and together with Mid-Valley Hospital in Omak, the place I work.
When providers shut down, they shut for the whole neighborhood, not simply Medicaid beneficiaries.
I agree with the crucial to root out “waste, fraud and abuse.” The issue is there isn’t very a lot waste to seek out. In 2024, 95% of Medicaid payments had been correct, in keeping with the Facilities for Medicare & Medicaid Companies, and 80% of improper funds had been because of inadequate documentation. The reality is that Medicaid is essentially the most environment friendly main well being care program within the nation. Overlaying low-income adults by means of Medicaid costs 45% less than non-public insurance coverage.
With the proposed Medicaid cuts, individuals won’t simply lose their well being care protection. When individuals are denied insurance coverage, they’re extra prone to find yourself sicker and to hunt uninsured care by means of emergency rooms. It would price sufferers, hospitals and the general public much more.
In my 13 years of observe, I’ve sought to strengthen our rural well being system. The applications we’ve constructed recruit and retain physicians, nurses and important workers, make use of neighborhood well being employees and case managers, construct higher scientific providers to assist sufferers navigate complicated and complicated programs of care, and rework well being organizations to be extra responsive.
This invoice places all that we’ve labored for in danger. Mass removing of sufferers from Medicaid and Apple Well being will destroy the expansion and high quality we’ve gained and the hopes now we have in additional enchancment of our programs.
Don’t take my phrase for it. Simply earlier than the vote in Might, greater than two dozen Republican state legislators wrote a letter to Washington state’s congressional delegation opposing Medicaid cuts. They wrote, “Merely put, we can not lose one other rural hospital or clinic, nor one other long-term care facility. We rely on a secure well being care system, and we’re counting in your management to make sure Medicaid’s survival.”
I agree with these legislators. Our state’s well being care system will be unable to face up to this invoice if it turns into regulation, and I encourage our members of Congress to considerably change it to guard Medicaid and guarantee sufferers can proceed to entry the care they want.
