While driving through West Texas on my way to New Mexico and Colorado last summer, I noticed that the Texas towns are (still) deader than doornails. Boarded up Main Streets. The only businesses still doing business the gas stations and Quickee Stops that cater to the drive by tourists who are on their way to Some Place Better.
Then I got to New Mexico. Imagine my surprise when I saw that Questa---as in polluted water thanks to the local molybdenum mine and poverty---now has a medical center with doctors and everything.
Go a few miles north over the border into some of the “poorest” areas of Colorado (“poor” being a relative thing) and you find that every small town has clinics and doctors and pharmacies and even hospitals. That’s because New Mexico and Colorado took the Medicaid expansion and now all their citizens have health insurance, meaning that providers can afford to move to where the people are---small towns.
Contrast the situation in New Mexico with that in rural Georgia, where no hospital or emergency room can stay in business, because the only people using their services are uninsured, meaning no revenue, just lots of uncollected bills.
Sucks to be poor, says the GOP. Except-—
Not everyone living in rural America is unemployed or uninsured. Some people have insurance. Some people have jobs. Some telecommute and prefer to live where the air is clean. Some own vineyards. Some raise horse or cattle. Some own the local hardware store or a fast food franchise that makes good money. Problem is, there is no place to use your health insurance if you live in a state in which no doctor or hospital can afford to set up in a small town, because the uninsured will drive you out of business faster than you can say Emergency Medical Treatment and Active Labor Act (EMTALA). And so, no major employer will relocate to a small town, because its well insured employees want doctors and hospitals. No one will invest in a town that has no health care.
All across America, small towns have been revitalized---in multiple senses of the word---thanks to the ACA and their new access to health care. What will happen to the clinic in Questa and all those hospitals in rural Colorado if the ACA vanishes and the local citizens are suddenly uninsured again? They will close up overnight---taking with them all the ancillary businesses that come with health care providers, like pharmacies, home health, durable goods, nursing homes, houses for those who deliver health care, schools for their kids, businesses that relocated because there are now doctors for their employees, school and houses for the new business workers, places for them to eat and shop-—
Rural America, Trump does not love you. The GOP does not love you. If they did, so many Red states would not have turned down free federal government money that would have made you and your community healthier. And now, they are going to try to undo what the Democrats have done for rural Blue states. Because they are just plain mean. There is no other explanation for it. Mean and spiteful and begrudging of even a dime spent on something besides themselves and their own special interests.