The evidence is in: the Medicaid expansion championed by Governor Bullock and Montana Democrats in the Legislature has not only saved lives, but it has saved rural hospitals in our state.
Lives first. Research by the National Bureau of Economic Research shows that over 15,000 died unnecessarily between 2014-17 because their states refused to accept Medicaid expansion. Mother Jones reports on the study:
“Since there are about 3.7 million individuals who meet our sample criteria living in expansion states, our results indicate that approximately 4,800 fewer deaths occurred per year among this population, or roughly 19,200 fewer deaths over the first four years alone,” the researchers wrote. “Or, put differently, as there are approximately 3 million individuals meeting this sample criteria in non-expansion states, failure to expand in these states likely resulted in 15,600 additional deaths over this four year period that could have been avoided if the states had opted to expand coverage.”
And now to the hospitals.
New reporting from Gatehouse News shows that rural hospitals across the country are in crisis and that those in states that rejected Medicaid expansion are much more likely to close:
- Rural America is in the midst of a deep and prolonged crisis that resulted in 106 hospital closures since 2010. Nearly 700 more are on shaky ground, and nearly 200 are on the verge of collapse right now, according to reports from Massachusetts consulting firm iVantage Health Analytics and the Sheps Center for Health Services Research at the University of North Carolina in Chapel Hill.
- Hospitals faring the worst are mainly in states that refused to expand Medicaid. Those states account for 77 of the 106 closures over the past decade. They also are home to a greater percentage of money losing facilities and lower collective profit margins.
Kansas illustrates the crisis Montana could have faced if Republicans got their way. The report notes that between 2011 and 2017, two out of three rural hospitals there lost money and five were forced to close.
And anyone who has lived in a rural area understands just how devastating it would be for a community to lose its hospital:
“A hospital closure is a frightening thing for a small town,” said Patti Davis, president of the Oklahoma Hospital Association. “It places lives in jeopardy and has a domino effect on the community. Health care professionals leave, pharmacies can’t stay open, nursing homes have to close and residents are forced to rely on ambulances to take them to the next closest facility in their most vulnerable hours.”
While Montana Republicans bray about socialism and argue they are defending “Montana values,” Montana Democrats–joined by a few sensible and courageous Republicans in the Legislature–fought to save lives and the rural hospitals that are vital economic and health drivers in their communities.
That’s not just good policy; it’s a moral imperative and Democrats should be proud of their efforts to fight for our communities.