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Lakeland closing signals need to reevaluate Medicaid expansion

Although Haleyville’s Lakeland Community Hospital was scheduled to close its doors December 31, 2017, the 87 employees set to be impacted received a three-month reprieve as the closing was delayed until March 31, 2018.

While the closing of a hospital that’s been a fixture in Winston County for decades is obviously bad news, the reasons cited for the closing of rural hospitals in Alabama follow predictable political party lines, depending on whom you ask.

Curae Health, a non-profit rural healthcare company, announced the closing of Lakeland in mid-November. The company also owns Russellville Hospital, Northwest Medical Center in Winfield and two Mississippi hospitals, Gilmore Memorial Hospital in Amory and Panola Medical Center in Batesville.

Plans call for the medical detox program at Lakeland to be transferred to Russellville Hospital. Curae officials have said Lakeland’s closing will not affect the operations of Russellville Hospital.

Unless the reasons for Lakeland’s planned closing are addressed, though, the reduction of Alabama’s rural hospitals seems inevitable. Once it closes, Lakeland will become the seventh Alabama hospital to close in the last nine years.

“Unfortunately, as with many other rural healthcare facilities in the Southeast, we are unable to continue operations due to drastic reductions in reimbursement,” said Debbie Pace, CEO of Lakeland Community Hospital in November.

Lakeland was set to see its reimbursements from the government reduced by almost $2 million, and Curae officials saw no viable option to continue operations.

U.S. Rep. Robert Aderholt (R-Haleyville), was quick to blame the Affordable Care Act, the bellcow of Barack Obama’s presidency, as the reason.

“This makes the fact that the House passed a repeal plan this year, only to see it fail in the Senate, all the more disappointing and devastating,” Aderholt said in a statement last year.

“I am deeply saddened to learn of the closing of Lakeland Hospital. As the only hospital in Winston County, its closure will be felt far outside of Haleyville. In addition to the Haleyville community and the entire area being impacted, dozens of people will lose their jobs at what should be a joyous time of year,” Aderholt added in his statement.

In 2014, then Gov. Robert Bentley announced he would not expand Medicaid, which was a provision of the 2010 Affordable Care Act and would have opened coverage up to Alabama residents living below 138 percent of the federal poverty level.

According to healthinsurance.org, an additional 435,000 Alabama residents would be covered if the state accepted expansion.

The act provided that the federal government would pay 100 percent of new enrollee costs the first three years of the expansion. That number would then drop to 90 percent.

According to the same website, that translates to $14.4 billion for health care not available for Alabama.

Combine that with the fact that Alabama has, by comparison to other states, low Medicare reimbursement rates. Medicaid reimbursement numbers in Alabama also fall below the national average.

Jim Carnes with Alabama Arise, an advocacy group for low-income families, believes the expanded Medicaid coverage would have been a great opportunity for Alabama.

“The health outcomes for the people of Alabama will improve, and we think it’s an economic win because there will be an infusion of federal tax dollars coming back to Alabama,” Carnes said in 2012.

Don Williamson, president of the Alabama Hospital Association, said the Medicaid expansion would significantly reduce the number of uninsured Alabamians.

Estimates after the passage of the ACA showed that Alabama would have to account for an extra $470-$693 million between 2014-2019 if the state expanded Medicaid, but that would result in $10 billion in new federal healthcare dollars.

“That’s a little like investing $500 and getting $10,000 back,” Williamson said in 2012, when he served as State Health Officer.

Whether through Medicaid expansion or some alternative means of funding, Alabama’s hospitals, particularly those in rural areas, are in dire need of improved reimbursement rates.

Otherwise, there will be more closings, making it more difficult for rural Alabamians to obtain quality health care in their communities.

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