Author: njfinn

The Trump supporters have put themselves in the cross hairs. The Affordable Care Act, which President-elect Donald Trump has vowed to repeal, has been a lifesaver for these vital but financially troubled centers. The health care law expanded Medicaid to cover tens of thousands of previously uninsured patients. This, in turn, provided new revenue for rural hospitals, which often serve a poorer, sicker patient population. The law also created a program that allowed some of these facilities to buy prescription drugs at a discount. “All these rural hospitals are operating on thin margins. The removal of any income source or coverage, or expansion of bad debt, is going to create significant financial hardship,” says Alan Morgan, CEO of the National Rural Health Association. Repeal of Obamacare without a similar replacement could force many of them to close. Ironically, 64 percent of the people here in Fayette County—one of the state’s poorest—voted for Trump. Pennsylvania, which has the third-largest rural population in the nation, played a pivotal role in his upset victory in November. Rural hospitals have long operated on the edge. In the past six years, more than 70 such facilities have closed, citing financial duress, and almost 700 more are at risk. Meanwhile, the need for reliable health care remains. Heart and lung disease are widespread in rural areas, and addiction to opioids is acute. Loss of local...