FRANCONIA, N.H. (AP) — Closing Ceremony Health center in rural New Hampshire They have expressed concern that the planned cuts to Medicaid are already taking a toll.
Last month, on the site of the Regional Medical Service of Ammonoosk, a Franconian town with a population of about 1,000 people, permanently closed.
Ammonosk officials and Democratic senators blame Medicaid cuts for the closure of the facility, which housed 1,400 patients in Franconia, Easton, Lincoln and Sugar Hill. These are all small communities around the White Mountains, and their patients are typically older and sicker than in other parts of the state.
Threats to rural health care
The closure of the Franconian regional center reflects the financial difficulties it faces community health center Amid concerns about Medicaid cuts and rising health insurance premiums, local health care systems are becoming more expansive. of government shutdownthe bill that ended last week was driven by Democratic demands to extend tax credits that allow low- and moderate-income people to buy health insurance through the Affordable Care Act (ACA).
More than 100 hospitals have closed in the past decade, and more than 700 more are at risk of closing, according to the Center for Healthcare Quality and Payment Reform, a policy and advocacy group. A branch of HealthFirst Family Care Centers, a facility in Canaan, New Hampshire, also announced it would close at the end of October, in part due to “changes in Medicaid reimbursement and federal funding” for these facilities.
NACHC says federally funded community health centers like those in Franconia are on average in the red, rely heavily on cash reserves, and may have to modify services or close locations to survive. According to the association, nearly half have cash on hand for less than 90 days. And the future is even bleaker, with at least 2 million community health center patients expected to lose Medicaid coverage by 2034 and 2 million additional uninsured patients turning to centers for care.
Difficult choices for CEOs
Ammonoosuc CEO Ed Shanshala said Medicaid cuts were the cause of the Franconia regional center’s closure.
Shanshala operates a network of five health centers in New Hampshire and relies on more than $2 million in federal funding out of a $12 million budget. He faced a $500,000 shortfall due to the cuts and realized he could save about half that money by closing Franconia. This was also the only facility where they rented space.
“We really don’t have a choice,” Shanshala said, adding that the closure would save $250,000. Additional savings are difficult to find, he said, given that the center serves people below 200 percent of the federal poverty level. And Shanshala worries that cutting additional services could mean some patients end up in hospital emergency rooms or “stop their medical journey.”
patient has difficulty adjusting
Susan Bushby, a 70-year-old housekeeper, said how much she loved the staff but was scared to go to the new health centre. She would not have found her way around a large facility and would not have been able to form the same relationships with the people there.
“I was very upset. I was really angry,” Bushby said, breaking down in tears as she talked about the challenges of starting over at a new health center. “I really like it there. I don’t know, I’m just going to really miss it. It’s really hard to explain, but it’s going to be sad.”
Marcia Luce, whose family moved from the Washington, D.C., area in 2000, is especially concerned about the impact on her 72-year-old husband, a former volunteer firefighter who had his left ear and part of his jaw removed due to cancer. He also has heart and memory problems.
She worries about longer wait times to see a doctor and the loss of relationships she has built over decades in Franconia.
“It’s going to be tough,” she said. “But it’s a relationship that you’ll miss. It’s a relationship that you can tell people and you tell them something and you’re gone, yeah, well, I have cancer. Oh, let’s see. Oh, yeah. It’s in your chart. You know what I mean?”
