At least five public hospitals closed this year and many more are scaling back services, mostly in states where Medicaid wasn’t expanded. Patients in areas with shuttered hospitals must travel as far as 40 miles (64 kilometers) to get care, causing delays that can result in lethal consequences, said Bruce Siegel, chief executive officer of America’s Essential Hospitals, a Washington-based advocacy group for facilities that treat large numbers of uninsured or low-income patients.This is life and death at its most basic, as usual hitting red state populations the hardest. Because it's rural areas that will the most affected, where people will have to travel much greater distances to get care in a medical emergency. That heart attack or stroke victim who has to be transported 40 miles, after having to wait for an ambulance to reach them from who knows where, is a lot more likely to die or be permanently disabled than someone minutes away from care.
“Everyone in a community will be affected,” Siegel said. “We could see the end of life-saving services, and patients would bear the brunt.”
Hospitals have dismissed at least 5,000 employees across the country since June, mostly in states that haven’t expanded the joint state-federal Medicaid health program for the poor as anticipated under the U.S. health overhaul known as Obamacare. Hospitals like the Cleveland Clinic in Ohio, Vanderbilt University Medical Center in Tennessee and Indiana University Health are among providers seeking cost savings in areas such as cancer treatment, mental health and infant care.
Republican governors and legislatures have made that choice, not just for the uninsured people in their states, but for everyone. You could have the best insurance available, but if you don't have a hospital to go to within minutes of an emergency, it's not going to make a damned bit of difference.