Medicaid Cuts: A Threat to Emergency Services and Rural Healthcare

As we celebrate National EMS Week, it is crucial to recognize the invaluable contributions of Emergency Medical Services (EMS) workers. These selfless heroes, many of whom are members of AFSCME, risk their lives daily to save others. However, their heroic efforts are under threat from a looming crisis: the proposed cuts to Medicaid.

The House Energy and Commerce Committee's draft legislation aims to reduce federal spending by $880 billion over 10 years, with significant cuts to Medicaid. The Congressional Budget Office (CBO) estimates that these cuts would decrease the federal deficit by more than $880 billion over 10 years, but at a devastating cost to healthcare services. The health provisions, including Medicaid, would reduce the deficit by $715 billion over ten years and increase the number of people without health insurance by at least 8.6 million by 2034.

The proposed cuts would have severe implications for rural healthcare, where access to medical services is already limited. Medicaid makes up a larger portion of rural residents’ insurance coverage, making rural hospitals and clinics more vulnerable to cuts in these programs. Nearly 40% of children living in rural communities are covered by Medicaid and CHIP, while almost 20% of non-elderly adults are covered. Cuts to these populations covered under Medicaid and CHIP would be devastating for rural families, as costs of care for the most vulnerable rural residents would rise to unsustainable levels.

If Medicaid funding is reduced, it will result in higher rates of uninsurance across the US, with a higher impact in the most vulnerable rural areas. These are parents, children, and working adults who would no longer be able to obtain needed health care due to it being unaffordable. Without coverage, many would go without care and end up in the emergency room or inpatient facility, resulting in uncompensated care that they will not be able to pay. This would increase the burden on EMS services, as they would have to respond to more emergencies and provide care to uninsured patients, further straining their resources and response times.

The closure of rural hospitals due to reduced Medicaid funding would exacerbate the situation. Rural hospitals are often the primary healthcare providers in their communities, and their closure would mean little to no access to local healthcare, forcing people to travel long distances for emergency, inpatient, or primary care. This would increase the response times of EMS services, as they would have to travel further to reach patients in need of emergency care. Furthermore, the closure of rural hospitals would result in a loss of jobs and a negative economic impact on the community, further reducing the ability of EMS services to operate efficiently.

The proposed cuts to Medicaid would also have severe long-term economic and social consequences on the healthcare infrastructure. According to the National Rural Health Association (NRHA), rural hospitals and clinics are heavily reliant on Medicaid reimbursements. The closure of rural hospitals is particularly devastating to the community, as healthcare tends to be one of the top three employers in a rural town and is a strong economic driver. Since most rural hospitals own and operate primary care clinics, when they close, so does that primary care office. That means little to no access to local healthcare, forcing people to travel a long distance for emergency, inpatient, or primary care. If a rural hospital closes, the negative economic impact is large, with businesses relocating and new ones not being started. Using an economic model from the American Hospital Association, our rural hospitals have shared that their facility contributes as much as $200,000 per hospital employee to their community. That means that if the hospital has 300 employees the total economic contribution is $60,000,000 per annum back to the rural community.

Ultimately, reductions in Medicaid funding will force rural facilities to shut their doors and rural residents to lose access to necessary care. NRHA calls on Congress to act as a unified, bipartisan voice to protect Medicaid funding that is vital to the health and economic sustainability of rural communities across the nation.

The proposed cuts to Medicaid are not just a financial issue; they are a moral one. They represent a failure to prioritize the health and well-being of our most vulnerable citizens. As we celebrate National EMS Week, let us also stand up for the care we depend on and the first responders who deliver it. We must not allow Congress to put billionaires ahead of our communities. The time to act is now, before it's too late.