Rural health care

Back in May, health care officials in our area were incredulous at the scale of the Medicaid cuts passed by the U.S. House in the so-called One Big Beautiful Bill Act, but remained confident that the Senate would never agree to cuts that threatened to so severely harm the nation’s health care system.
Such confidence proved unrealistic as the Senate version of the bill was even worse. Based on estimates from the Congressional Budget Office, the House version of the bill would have cut $800 billion over ten years from the Medicaid system. The Senate version, which the House passed late last week, is estimated to lop nearly $1 trillion off Medicaid, a scale of cuts that no one could have imagined. More importantly, no one knows the full implications of the cuts because those impacts were never explored by Congress. The mission of the One Big Beautiful Bill was to make permanent tax cuts that overwhelmingly favor the wealthy and pay for it by slashing the social safety net. The Republicans who currently control Congress never had any interest in highlighting the implications of its draconian cuts to Medicaid, food benefits, and housing assistance.
Congress’s own nonpartisan analysts have concluded that the measure signed into law on July 4 will leave the poor and working classes worse off, while those at the top of the income ladder will see big financial gains. For all the populist talk from the GOP these days, when push comes to shove, the party never deviates from its number one priority: Tax cuts for the rich. They’ll leave crumbs for the rest of us.
Meanwhile, rural residents, including those of us here in the North Country, are now test subjects in a nationwide experiment to see what happens when a major revenue stream that has kept rural hospitals and clinics above water for the past 15 years, fades away. As we report this week, those in charge in places like Scenic Rivers Health Services or our local hospitals are in shock as they try to contemplate a future that is guaranteed to include staffing reductions, service cutbacks, and very likely the closure of some facilities that serve our region.
The implications of the Medicaid cuts will be personally devastating for the hundreds of thousands of Minnesotans who will now lose their health coverage, but the impact will hit everyone as the health care system is hollowed out over the next several years. As we’ve noted previously, it will be rural hospitals and clinics that are hit the hardest because they serve a patient load that relies heavily on Medicaid. As their patients lose that coverage, the funding stream that allowed organizations like Scenic Rivers to expand to places like Tower will disappear. While facilities will likely hang on for a few years, the longer-term outlook is now bleak. The bottom line is, you can’t cut nearly $1 trillion from the nation’s health care system without major impacts that people will feel.
Even as this disaster unfolds, the GOP and their mouthpieces in the media will spin this as protecting Medicaid by implementing work requirements that will ensure coverage for those who truly need it. That’s bunk. We’ve seen how work requirements play out, and the process is so complicated and requires so much paperwork that many Medicaid recipients, particularly those who aren’t computer savvy or lack home internet, will find it nearly impossible to complete. Most of those who lost coverage due to work requirements in Georgia were, in fact, working, but couldn’t navigate the gauntlet of paperwork required on a monthly basis and eventually lost their coverage. Work requirements aren’t intended to get people to work, after all – they’re intended to kick people off coverage whether they’re working or not.
It’s worth noting here that Minnesota’s Eighth Congressional District is heavily served by community health centers, such as Scenic Rivers. About 25,000 residents of the district are now likely to lose their health coverage over the next few years and some of the clinics and hospitals in the region will likely close, limiting access and leading to job losses in the area. In most small communities that are home to a hospital or clinic, the facility is the community’s largest employer.
A congressman who truly represented the people of the Eighth District would never have supported these kinds of changes. But the Republican Party is now the Trump Party and that means GOP members of Congress are there to serve Trump’s ego, not their constituents. Any Republican member who puts his or her state or district first is quickly forced into retirement. The vast majority seem more interested in maintaining their perks and privileges than in bringing forward policies that make their constituents’ lives better. The One Big Beautiful Bill is Exhibit A.