The Medicaid Expansion Debate May Come Down to Rural Hospitals, Which Could Need it to Survive

Apr 4, 2018

Rural Virginia hospitals may end up playing a significant role in the ongoing debate over Medicaid expansion.

Rural hospitals are in a fix. Because so many people in rural areas don’t have health insurance, hospitals in far-flung parts of the commonwealth are stuck with the bill to see uninsured patients in the emergency room. Beth O’Connor at the Virginia Rural Health Association says more than 80 rural hospitals across the country have closed since 2010.

“Two thirds of those are in states that have not expanded Medicaid. So while Medicaid expansion may not be the magic wand, it’s certainly a big piece of the puzzle for those small rural facilities.”

She says expanding Medicaid would help rural hospitals keep their doors open, although rural communities have traditionally stood in opposition to expanding Medicaid.

Credit Mark Goebel / Flickr

Quentin Kidd at Christopher Newport University predicts that’s about to change. He says it’s no accident that the leading House Republican to flip on Medicaid expansion was Terry Kilgore, who represents the rural southwest corner of Virginia. Kidd says he expects Republicans in the Senate to follow suit.

“And it wouldn’t surprise me if a good number of them were rural senators because they all know that at the end of the day the dollars and cents are going to be meaningful to their rural hospitals and they need those rural hospitals to stay open.”

So far, none of the Senate Republicans has announced a change of position on Medicaid expansion. But a special session is scheduled later this month, so senators on both sides of the issue are being heavily lobbied behind the scenes right now.

This report, provided by Virginia Public Radio, was made possible with support from the Virginia Education Association.