In case you missed it, the USA today published the following investigative report yesterday: “Rural hospitals in critical condition: ACA accelerates demise of rural hospitals that serve many of society’s most vulnerable” This article has an embedded video with the following caption: “Dozens of rural hospitals have closed since 2010 due in part to the Affordable Care Act.”
Jayne O’Donnell and Laura Unger devoted most of the article to the life and death consequences of such closings. They also alluded to the notion that the decisions of many states not to accept Medicaid expansion under the Affordable Care Act (ACA) was a contributing, but not deciding, factor in such rural hospitals closings (without mentioning that such decisions were made exclusively by Republican-led states).
So how is the ACA responsible for these closings? I read this article thoroughly and, I hope, with an open mind. As far as I could tell, two specific reasons were given that directly apply to the ACA. First, the law penalizes hospitals if and when they have to re-admit patients soon after they’ve been released. Second, the law requires hospitals to transition to electronic health records.
With regard to the former reason, if a hospital receives lower reimbursements because it’s providing substandard care, then that’s the hospital’s fault, not the ACA’s. With regard to the latter reason, the article reports that the U.S. Department of Health and Human Services “awarded $100 million to states in July so they could provide grants for technical support…” I don’t know if that amount is sufficient because, well, the authors don’t tell us.
O’Donnell and Unger also wrote that “low Medicare and Medicaid reimbursements hurt these hospitals more than others because it's how most of their patients are insured, if they are at all.” However, I’m not sure what that has to do with the ACA. Medicare and Medicaid reimbursement rates have traditionally been lower than those paid by private insurers and, to my knowledge, the ACA did not reduce them even further except, as previously mentioned, when substandard care is provided.
In short, USA Today’s seemingly misleading headline and insufficient reporting only serves to reinforce the false notion that the Affordable Care Act does more harm than good among those who don’t pay as close attention to the subject as we do. And that’s a damn shame.
Anyway, check out the article and feel free to let me know if I've missed anything.