Grady hospital in Atlanta shows the difficulty for safety net hospitals in states that don't expand Medicaid. (photo: David Goldman/AP)

Fourth Georgia Hospital Shuts Down As the State Continues to Refuse Medicaid Expansion

By Sy Mukherjee, ThinkProgress

18 February 14

or the fourth time in two years, a rural hospital in Georgia is shuttering its doors over a dearth of patients who can pay for their medical services, the Albany Herald reports. An increasing number of hospitals that serve large numbers of poor and uninsured Americans are being forced to close in states that are refusing the Affordable Care Act's Medicaid expansion.

 

The Lower Oconee Community Hospital, a so-called "critical access" hospital in southeastern Georgia with 25 beds, will close down and possibly re-open as an urgent care center that provides services that aren't quite serious enough to necessitate an emergency room visit. Patients in the Wheeler County region who need more extensive medical care after the hospital closes will need to travel upwards of thirty miles in order to receive it.

 

"We just did not have sufficient volume to support the expenses," said CEO Karen O'Neal in an interview with local CBS affiliate WMAZ. "It's a terrible situation, and it's tragic, the loss of jobs and the economic impact."

 

Last fall, Bloomberg reported that at least five public hospitals in Georgia, North Carolina, and Virginia - including three in Georgia alone - were cutting staff and services in the wake of their refusal to expand Medicaid. These hospitals are so-called "Disproportionate Share Hospitals" - providers that serve a disproportionate number of poor and uninsured Americans, and as such don't always receive payments for the care they give patients.

 

About one in four people in Wheeler County, where the latest hospital is shutting down, is uninsured.

 

About one in ten residents are unemployed and over 40 percent of children live in poverty.

 

As the Albany Herald reports, experts agree that offering higher Medicaid reimbursement rates for rural hospitals and accepting Obamacare's Medicaid expansion, which would extend health benefits to all Americans who make up to 138 percent of the Federal Poverty Level (FPL), would provide major financial security to hospitals in lower-income regions.

 

Approximately five million working poor Americans who live in states refusing Obamcare's Medicaid expansion will fall into a coverage gap where they make too much money to qualify for existing state Medicaid programs but too little money to qualify for the ACA's insurance subsidies.

 

Nearly 500,000 Americans in this coverage gap reside in Georgia.

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