Too many of Idaho‘s rural hospitals are struggling to stay open and the situation is getting worse. They took a big hit last summer when the One Big Beautiful Bill Act cut nearly $1 trillion from Medicaid over the next decade. To soften the impact of those cuts, Congress included a section in OBBBA entitled “Protecting Rural Hospitals and Providers” which established the Rural Health Transformation Program (RHTP). They allocated $50 billion in funding over the next five years to support rural health initiatives across the country. In December, Idaho was awarded almost $186 million annually and the clock started ticking to get those funds out to rural hospitals before the first deadline passes.
At a Glance:
- Idaho was awarded almost $186 million annually through the Rural Health Transformation Program in December.
- A January report found 10 Idaho rural hospitals at risk of closure, up from seven 18 months ago.
- Idaho Legislature has not approved spending authority for RHTP funds, delaying support to rural hospitals.
The challenge? These funds cannot reach our communities until spending authority has been approved by the Idaho Legislature. The Senate and the House want to assure they have oversight of the program but have yet to agree on how RHTP funds should be spent. While lawmakers debate the process, rural hospitals continue to struggle.
A January report determined 10 Idaho hospitals are at risk of closure. That is up from seven just 18 months ago. We will be able to measure the success of the RHTP by the number of hospitals we are able to keep open. If a hospital closes after these funds have been distributed, we will know we have failed. Many hospitals around the country are already feeling relief from their state’s RHTP funds while our hospitals sit in uncertainty. At this point, I worry that a hospital may close before a penny makes it through the legislative approval process.
Our rural communities deserve access to care, not punishment for their zip code. Travel time, transportation and financial constraints are all barriers to care that rural patients experience, leading many to delay or put off care all together. Patients are more likely to seek needed treatment if care is available to them locally which makes for better health care outcomes. When it comes to emergency care, nearby services save lives. Extended travel times are directly linked to higher mortality rates and increased strain on health systems. Keeping rural facilities open is imperative to public health. Where you live shouldn’t dictate if you live.
Without health care infrastructure, communities will suffer from more than just closed hospitals and longer distances for care. When rural hospitals close, the local economy is threatened. Local industry will struggle to attract and retain workers if health care isn’t available to them. If we want our children and grandchildren to be able to stay in their hometown, we need employment options. Health care services support communities, provide essential services, and stimulate the economy in ways that cannot be replicated from afar.
The negative impact of a rural hospital closure is not limited to small communities. Every hospital in our state cares for rural patients. If a small hospital closes, larger hospitals will feel a sudden influx of rural patients at a time when they are already trying to keep up with rapid growth. The more Idahoans that can be cared for in their own community, the better it is for everyone.
Congress has made an attempt to invest in rural health, and it is time for the Idaho Legislature to make sure these funds make it to our rural communities before the clock runs out.
Toni Lawson is the chief advocacy officer for the Idaho Hospital Association.