In southern Colorado’s San Luis Valley, clouds billow above the towering mountains of the Sangre de Cristo vary. A refrain of blackbirds whistle as they flit among the many reeds of a wildlife refuge. Massive, round fields of crops, interspersed with native shrubs, give it a really feel of bucolic quiet.
However amid the stark magnificence in one of many state’s most productive agricultural areas, there was a way of unease among the many neighborhood’s leaders as Congress debated a finances invoice that would radically reshape Medicaid, the federal government well being program for low-income individuals.
“I’m trying to be worried and optimistic,” stated Konnie Martin, CEO of San Luis Valley Well being in Alamosa, Colorado, the hub for well being care companies for 50,000 individuals in six rural counties.
Martin stated Medicaid is important to rural well being care.
“I think in Colorado right now, nearly 70% of rural hospitals are operating in a negative margin,” within the crimson, Martin stated.
The well being system’s annual finances is $140 million, and Medicaid income makes up almost a 3rd of that, in line with Shane Mortensen, chief monetary officer for SLV Well being.
The working margin is razor-thin, so federal cuts to Medicaid might pressure tough cuts at SLV. “It will be devastating to us,” Mortensen stated.
The area is likely one of the state’s poorest. In Alamosa County, 2 in 5 residents are enrolled in Well being First Colorado, the state’s Medicaid program.
It’s a lifeline, particularly for individuals who wouldn’t in any other case have easy accessibility to well being care. That features low-income seniors who want supplemental protection along with Medicare, and folks of all ages with disabilities.
Envisioning a future with deep Medicaid cutbacks leaves many sufferers on edge.
“I looked into our insurance and, oh my goodness, it’s just going to take half my check to pay insurance,” stated Julianna Mascarenas, a mom of six. She stated Medicaid has helped her cowl her household for years. Mascarenas works as a counselor treating individuals with substance use issues. Her ex-husband farms — potatoes and cattle — for employers that don’t provide medical health insurance.
Throughout the state, Medicaid covers 1 in 5 Coloradans, greater than one million individuals.
That features youngsters in foster care.
“We’ve had 13 kids in and out of our home, six of which have been born here at this hospital with drugs in their system,” foster mum or dad Likelihood Padilla stated, referring to SLV’s flagship hospital in Alamosa.
“Medicaid has played a huge part in just being able to give them the normal life that they deserve,” he stated. “These kids require a lot of medical intervention.”
Chris Padilla, Likelihood’s husband, stated: “At one point, we had a preteen that needed to be seen three times a week by a mental health professional. There’s no way that we could have done that without Medicaid.”
Employees and directors at SLV Well being ponder whether federal cuts will make it onerous for the system to maintain its most cancers middle working.
“It could be pretty dramatically affected,” stated Carmelo Hernandez, SLV’s chief medical officer.
The hospital in Alamosa has its personal labor and supply unit, the kind of service that different rural hospitals throughout the U.S. have struggled to maintain open. About 85% of the hospital’s labor and supply sufferers are coated by Medicaid, Hernandez stated.
“If we don’t have obstetric services here, then where are they going to go?” stated Hernandez, whose specialty is obstetrics and gynecology. “They’re going to travel an hour and 20 minutes north to Salida to get health care. Or they can travel to Pueblo, another two-hour drive over a mountain pass.”
Tiffany Martinez, 34, was not too long ago compelled to consider that chance after giving beginning to her fourth youngster.
Her being pregnant was high-risk, requiring twice-a-week ultrasounds and stress exams on the hospital. She’s enrolled in Medicaid.
“Everything down here is low-pay,” Martinez stated. “It’s not like we have money to just be able to pay for the doctor. It’s not like we have money to travel often to go to the doctor. So it’s definitely beneficial.”
Offering Well being Care — And Jobs
With 750 employees, the well being system is the valley’s largest employer. Clint Sowards, a main care doctor, stated having much less Medicaid funds will make it tougher to draw the following technology of medical doctors, nurses, and different well being care employees.
Sure medical specialties may not be out there, Sowards stated. “People will have to leave. They will have to leave the San Luis Valley.”
Kristina Steinberg is a household medication doctor with Valley-Large Well being Methods, a community of small clinics serving 1000’s within the area. She stated Medicaid covers most nursing residence residents within the space. “If seniors lost access to Medicaid for long-term care, we would lose some nursing homes,” she stated. “They would consolidate.”
Audrey Reich Loy, a licensed social employee and SLV Well being’s director of packages, stated the system makes use of Medicaid “as sort of the backbone of our infrastructure.”
“It doesn’t just support those that are recipients of Medicaid,” she stated. “But as a result of what it brings to our community, it allows us to ensure that we have sort of a safety net of services that we can then expand upon and provide for the entire community.”
In search of Extra Effectivity
Republicans in Congress who pushed for the large spending and tax regulation, which estimates counsel will end in giant cuts to Medicaid, say they need to lower your expenses and make the federal government extra environment friendly.
Many within the Alamosa County area voted for Donald Trump. “He’s potentially affecting his voter base pretty dramatically,” Hernandez stated.
He stated Medicaid cuts might give President Trump’s supporters second ideas, however he famous that politics is a delicate matter that he principally doesn’t focus on with sufferers.
Sowards stated he understands that some individuals consider the Medicaid system is ailing and expensive. However he stated he has grave doubts concerning the proposed treatment.
“Losing Medicaid would have drastic repercussions that we can’t foresee,” Sowards stated.
Cuts Would Create Ripple Impact
SLV Well being’s regional financial impression is greater than $100 million a 12 months, with Medicaid accounting for a serious a part of that, Martin stated.
Any Medicaid cuts would hit the well being system onerous, however they’d additionally have an effect on small companies and their workers. The area is feeling financial stress from different adjustments, like latest cuts the Trump administration made to the federal workforce.
The San Luis Valley is residence to the Monte Vista Nationwide Wildlife Refuge, Nice Sand Dunes Nationwide Park, and different federally managed lands.
Joe Martinez, president of San Luis Valley Federal Financial institution, stated that not too long ago laid-off federal employees are already coming to banks saying: “‘Can I find a way to get my next two months’ mortgage payments forgiven? Or can we do an extension?’ Or: ‘I lost my job. What can we do to make sure that I don’t lose my vehicle?’”
Ty Coleman, Alamosa’s mayor, traveled to Washington, D.C., in April to speak to Colorado’s congressional delegation. He stated his message about Medicaid cuts was simple: “It can have a devastating economic impact.” Coleman put collectively an extended listing of attainable troubles: Extra power illness and better mortality charges. Longer wait instances for care. Medical debt and monetary pressure on households.
“It’s not just our rural community but the communities, rural communities, across Colorado as well, and the United States,” Coleman stated. “And I don’t think people are getting it.”
This text is from a partnership that features CPR Information, NPR and KFF Well being Information.
