AUSTIN, Texas – A new report warns that rural hospitals in Texas could be hit hardest under a Congressional plan to repeal and replace the Affordable Care Act.

It found that proposed funding cuts to the Medicaid program, which already is operating at a minimal level in Texas, could force many rural hospitals to close, leaving hundreds of thousands of people without reasonable access to health care.

David Pearson, director of the Texas Organization of Rural and Community Hospitals, which produced the study, said a new round of funding cuts could devastate the state's already challenged rural health-care system.

"Continual reduction in reimbursements and available financial resources, either at the state or the federal level, have just gotten to the point where a lot of small hospitals are unsustainable," said Pearson. "They don't have the local tax support to make up that difference."

According to the report, the state's rural health-care system faces declining reimbursement rates along with rising health-care costs, and Texas already has the highest uninsured rate in the United States.

When Texas lawmakers did not expand Medicaid under the ACA, Pearson said, it put dozens of rural hospitals on the critical list.

He said 16 rural hospitals in Texas have closed since 2013, with an increasing number in financial distress. Pearson also explained that a proposed plan to fund Medicaid through block grants would only shift the financial burden of rural health care to those who can least afford it.

"Local governments and/or local tax districts already fund a large share of Medicaid," he said. "The tax base in a rural area just isn't large enough to be able to generate the kind of revenue that would be needed to offset that reduction."

Pearson said when a rural hospital closes, it creates a damaging ripple effect in the local economy. He added that Texas isn't the only state facing a rural health-care crisis.

"This really is a national crisis," he warned. "Unfortunately, Texas leads the way as far as the number of closures, but closures across the country in rural areas are really starting to add up."

The report, which was completed before the Republicans' current American Health Care Act was released, was sponsored by the nonprofit Episcopal Health Foundation.




get more stories like this via email

October is Breast Cancer Awareness Month and health professionals are urging women to get screened at earlier ages than previously suggested.

After skin cancer, breast cancer is the most diagnosed form of cancer for women in the U.S.

Dr. Anne Gayman, a family medicine physician at Kaiser Permanente in Seattle, said there has been an increase in breast cancer rates in women in the 40- to 50-year age range. She noted previous recommendations called for women to speak with their health care provider after age 40 about when to start screening.

"These new recommendations from the United States Preventative Services Task Force state that all women should begin screening now at age 40, and repeat screening every other year through age 74," Gayman explained.

About one in eight women will develop breast cancer in their lifetime, according to the American Cancer Society, which also said breast cancer rates in Washington state are higher than the national average and screening rates are lower. The state has the ninth-highest cancer rate in the country, and the 10th-lowest screening rate.

Gayman said it is unclear what is driving up the numbers for younger women.

"We don't know, but we know that younger women can get often quite aggressive forms of cancer," Gayman pointed out. "These new recommendations help us to get more young women having regular screenings, which can help to intervene earlier."

Gayman emphasized there are new treatments to target breast cancer and more research is being done because some forms are still hard to treat and acknowledged some big improvements in breast cancer survival rates.

"A lot of that is thought to be due to the increased rates of screening, because the earlier we catch breast cancer the more treatable it is, right?" Gayman added. "If we can catch it before it's moved outside of the breast, your prognosis is much better."

A community health center in East Tennessee is offering essential medical services on wheels, to families cleaning up after Hurricane Helene.

Cherokee Health Systems in Knoxville has sent out its mobile clinic, equipped with exam rooms, a lab and telemedicine capabilities.

Dr. Parinda Khatri, CEO of Cherokee Health Systems, said it has been stationed at places like community parks, gas stations and church parking lots, to provide comprehensive first aid and health care, along with mental health support.

"This week, we are focused on the community center, and we're offering medical care, behavioral health via telemedicine," Khatri outlined. "Because people are experiencing quite a bit of trauma. So, we are giving hepatitis A vaccinations, because of the risk with the contaminated water, and also tetanus shots."

Gov. Bill Lee recently announced a $100 million Helene Emergency Assistance Loans Program to help Tennesseans in counties affected by the hurricane. HEAL funds will be used to repair water and wastewater systems and remove dangerous debris.

Khatri emphasized her pharmacy's involvement is crucial due to people's ongoing needs for medications. The mobile medical clinic is also addressing basic care needs, distributing items like baby formula, diapers and blankets. She added the mobile clinic prioritizes providing care regardless of cost and has not turned anyone away due to financial reasons.

"We have been giving out water, a tremendous amount of water," Khatri observed. "We've been giving out personal hygiene kits, emergency medical kits, wound care supplies, because people have come in with injuries. We are giving all of those resources that, you know, the medical supplies that they need."

She noted the community has never experienced such widespread destruction and it is unclear how long the recovery will take. The psychological effects of the disaster are significant, as people recount being rescued from their homes and losing contact with loved ones. The trauma of rebuilding and the financial, emotional and physical strains will likely have lasting impacts.


get more stories like this via email

Following Hurricane Helene, Hurricane Milton left a trail of destruction across the Sunshine State and the combination has pushed some Community Health Centers to their limits.

While some were spared from structural damage, other clinics were not so fortunate. The Florida Association of Community Health Centers represents 54 health centers across the state that see patients regardless of their ability to pay.

Jonathan Chapman, CEO of the association, said more than 30 service locations have been significantly damaged by the storms, which has prompted deep concerns about the health center network.

"I talked to a health center just a few minutes ago," Chapman recounted. "They just went on one of their sites this morning, only to find out that all the windows were smashed in from the storm; the rain, the wind caused damage."

He noted closing the six centers in the immediate Tampa area would mean at least $1.6 million a day in lost revenue. While national disaster agencies are offering assistance with mobile units and temporary locations, Chapman emphasized the available funding falls short of covering operational costs, especially as many centers had already depleted their reserves from Hurricane Helene.

Chapman added he has been frustrated with the federal response, particularly the lack of immediate financial relief for operational costs. However, he pointed out the clinics are doing their best to remain fully operational where possible, using whatever resources they can get.

"We're looking at smaller grants, maybe $10,000 or $15,000, from here and there," Chapman explained. "If we're looking at $1.5 million to $2 million a day, as good as that sounds, that's barely scratching the surface."

Chapman added in some cases, federal funding, including FEMA aid, will not be accessible for months. In Congress, House Speaker Mike Johnson faces pressure to reconvene lawmakers to pass more FEMA funding for recovery, but Johnson insists funding is not the issue, pointing to the $20 billion Congress previously allocated to FEMA.