In replacing Obamacare, restore hospital payments

Cindy Greer
Cindy Greer

With the inauguration of President Donald Trump, the discussion about how to repeal and replace the Affordable Care Act (ACA) has intensified. Hopefully, lawmakers on both sides of the aisle will see the debate as an opportunity as much as a challenge. Even the most fervent proponents of the law acknowledge it’s far from perfect.

Among other things, huge cuts to Medicare reimbursements for community hospitals like those that serve small towns and rural areas in Colorado must be restored to the same levels they were set before the ACA went into effect.

It’s historically been challenging to attract investors to build any kind of infrastructure in the more sparsely populated regions of the country. This is particularly true for rural health care facilities. Returns on investments in serving smaller communities aren’t guaranteed, and the ACA has made it a far riskier proposition.

Currently, the Congressional Budget Office claims nearly half of all hospitals could end up with negative operating margins under the ACA in its current form. In the face of such measures, consolidating services in urbanized areas simply makes more economic sense. But that’s cold comfort for rural residents who have to travel long distances to access care.

It’s critical to get adequate funding for hospitals and other facilities in rural areas, and that means repealing the hospital Medicare cuts that were part of the ACA. Telemedicine and other innovations help rural residents, but such assets can never replace a brick-and-mortar hospital where patients meet their doctors face-to-face. Asking a seriously ill person who needs treatment or even a healthy person who needs preventive care to travel an hour or more to a hospital isn’t practical and will end up costing more in the end.

Underserving rural communities will ultimately undermine the nation’s entire economy because our farmers, ranchers and small business owners are its backbone. Without a solid agricultural base, even our most technological sectors won’t flourish. These hard-working men and women feed the country and supply the raw materials we need to prosper. We can’t forget them and neglect their health if we hope to remain a strong and resilient country. Supporting all hospitals must be a priority for any new health care law.

I have a keen understanding of the importance of rural communities as a leader of the Colorado State Grange. We work hard to ensure those in our communities have access to the things they need to live healthy, safe and happy lives. If we can’t sustain ourselves, the rest of the country will suffer as well.

Our leaders must appreciate that allowing rural hospitals to continue to decline or even close due to steep cuts to Medicare constitutes a moral issue. Repealing and replacing Obamacare has to involve returning to the Medicare rates community hospitals in rural areas depended on before the law was put in place.

Cindy Greer serves as president of the Colorado State Grange, an organization that strives to provide opportunities for individuals and families to develop to their highest potential to build stronger communities and states as well as a stronger nation. For more information, visit