A pop up from a former Rippey resident came on my Facebook page three days ago. “In order to get on Medicaid, I’m needing to get a job. I have not been having luck finding something that would work for me. I’m only needing something for a minimum of 8 hours a month to qualify, willing to do more, just can’t make too much per month to keep on Medicare. Please contact me if you know of a contact for a service that helps place people with disabilities.” This plea is from a resident who is paraplegic, meaning his lower extremities are paralyzed. He is currently residing in a nursing home.
Then this occurred….
At a recent meeting of the Greene County Development Corporation board, an aide to Sen Joni Ernst, Britany Corrine Rockwell, was present. As the business meeting was concluding, Greene County Medical Center CEO Chad Butterfield requested the aide carry a message to the senator. Chad asked that the senator be aware of the impact that cuts to Medicaid will have on Greene County Medical Center.
While addressing her, he was also talking expressly to the leaders of Greene County gathered around the table. “Greene County Medical Center receives 16 percent of our revenue from Medicaid. If those funds are no longer available, people receiving Medicaid services will continue to need hospital services. We,” (and he expressed with his hands to the group) “will be paying for those services through our taxes.”
According to the Center for Healthcare Quality and Payment Reform, 20 rural Iowa hospitals are at risk of closure, with five facing immediate risk of shutting down. These closures are primarily due to a combination of financial pressures, including low reimbursement rates from Medicare and Medicaid.
The Cedar Rapids Gazette reported on June 21 a quote from the American Hospital Association, that plans by Senate Republicans to scale back a Medicaid provider tax that states like Iowa use to fund their Medicaid program could deal a greater financial blow to rural hospitals. Many rural Iowa hospitals operate at a loss, with private insurance reimbursements often not covering the cost of care. Forty-eight percent of rural hospitals operated at a financial loss in 2023. Nationwide a total of 92 rural hospitals have closed their doors or been unable to continue providing inpatient services over the past 10 years.
Chris Mitchell, chief executive officer of the Iowa Hospital Association, was quoted in the June 21 Cedar Rapids Gazette explaining, “We are required by federal law to treat every patient that comes in our door (and) stabilize them, regardless of their ability to pay.” Mitchell continued, “So, if you can’t (pay), that leaves hospitals in a bind. Either they have to reduce the number of services that they offer to reduce costs and/or reduce the number of staff that they pay to work there. And my point is, these cuts are coming to Medicaid, but it impacts the entire community, because when a service leaves the hospital, it doesn’t matter what kind of insurance that you have, if it’s not there, the services aren’t there and you can’t access them, right?”
Nearly half, 47 percent, of rural births in the United States are covered by Medicaid, and 65 percent of nursing home residents in rural counties are covered by Medicaid.
Currently combined Medicaid coverage in Greene County according to the Iowa Department of Health and Human Services is 20.4 per cent. This is compared to a statewide Iowa coverage of 20.9 percent and comes from 2023 data.
Greene County Medical Center, according to its website, employs 210 employees. Through the efforts of the Greene County board of supervisors and the taxpayers of Greene County, the Medical Center is being maintained. Senators Ernst and Grassley are working on the budget bill at the time of this writing. I hope they will advocate for rural Iowa hospitals and health care for rural Iowans.
VIEW FROM MY WINDOW is shared by Mary Weaver of rural Rippey.
