LANSING — With federal funding cuts already on the horizon, Northern Michigan’s largest hospital systems are warning that access to rural healthcare would suffer under the state House’s funding proposal.
“The kinds of decisions we are looking at and the service line reductions that we’re looking at because of federal changes — we might have to accelerate some of those decisions,” said Deidra Wilson, vice president of government relations for McLaren Health Care.
Northern Michigan counties have an average Medicaid enrollment of 25%, close to the state’s level.
Counties like Clare, Lake and Wexford have enrollment rates closer to 33%, while Charlevoix, Emmet and Grand Traverse have less than 20% of residents enrolled.
“From a standpoint of who gets impacted the hardest and first, if there are impacts — when there are impacts — it’s rural health care,” Wilson said.
Gabe Schneider, director of government relations for Munson Healthcare, says that about 60% of Munson patients receive insurance through the state or federal government.
“When you make changes at either level, it has a significant impact on our overall ability to deliver care to all patients — because when you make changes to the funding sources for Medicaid, for example, you don’t just impact Medicaid patients,” he said.
Schneider says that Medicaid cuts could cost the system in two ways — by directly reducing hospital revenue and by creating a larger uninsured population.
Uninsured people are less likely to be able to access cheaper preventative healthcare, leading to a demand for costly emergency care later in life.
“We see all patients, regardless of their ability to pay, and so we need to make sure that we remain available to all patients,” Schneider said.
Wilson, with McLaren, says that OB/GYN and pregnancy services are often some of the first cuts considered by providers when faced with financial troubles, decisions that can impact all potential patients.
“That’s not just for Medicaid recipients in a region — that’s for all moms of babies,” she said.
Wilson also says she’s concerned the proposal would undo investments in areas like behavioral health.
“We don’t want to see that roll backwards,” she said. “A situation where you’ve taken one step forward and then this — and cuts like these would take you two steps back.”
The House plan does include $250 million from the Rural Health Transformation Program, an initiative included in the federal budget bill to offset some of its cuts to Medicaid.
That program is set to provide $10 billion a year over the next five years — but rural health providers say that the funding won’t fully replace lost Medicaid revenue.
“As cuts go deeper and deeper, we have to make incredibly difficult decisions at service lines — and what kinds of things we can provide in communities,” Wilson said.