“We need some hope”: Can a rural hospital on the edge survive Trump’s bill? |Missouri

When her severely allergic toddler Josie started to take a breath late at night, Krissy Cunningham knew there was only one place to catch up in time to save her daughter’s life.

For 74 years, the Pimmyscott Memorial Hospital has been a destination for those who have experienced disasters in the poorest county of Missouri, a rural farm and town in its southeastern Bhutall region. Three stories about Brown Bricks near Interstate 55 in Helty Township, even when the county’s only Walmart closed, the ranking of boarding gas stations along the highway exit was gradually declining the population of surrounding towns, which was not enough to bring it down in the Tornadoes.

For many in Pemiscot County, its emergency room is closest to the closest, without having to drive a 30-minute drive to Tennessee or the state line in the Mississippi River, or to Arkansas, a range that can make life and death different from shootings, overdoses, or accidents on the road. In the early hours of one spring morning, Josie received respiratory therapy and semi-popular adrenaline shots, causing her breathing to drop.

“I would never have taken it to a hospital further away if I weren’t here. Her respiratory tract would be closed and I might have CPR on my daughter on the roadside,” recalled Cunningham, a nurse on the hospital board.

However, the days it serves the community may be numbered. In May, the hospital’s government publicly released the news that they may have to shut down after years of uninsured patients’ misery and insurers’ reimbursement rates are low. Even if they do manage to get rid of the current crisis, leaders of the Pimmy Scott Memorial see new dangers: Republicans pushed for the “big and beautiful bill” earlier this month, according to Donald Trump’s request.

The bill centers on funding from a series of tax cuts and presidential mass deportation programs, which would require historical reductions in funding to support federal health care programs for low-income and disabled Americans. This is expected to have a ripple effect nationwide, but it will be particularly hit in Pemiscott County and other rural areas, where hospitals tend to have fragile profits and are disproportionately relying on Medicaid to make ends meet.

“Will we even collect what we collect now if Medicaid drops?” asked Jonna Green, chairman of the board of directors of Pemiscot Memorial, asked 80% of his income from Medicaid and Medicare, another federal health program that is primarily targeted at people aged 65 and 65 and older. “We need some hope.”

Medicaid changes will begin at the end of 2026 and require participants to work 80 hours a month, voluntarily or attend school for 80 hours. States should also face new caps for provider taxes, which they use to fund their Medicaid. All in all, non-partisan Congressional Budget Office predicts 10 Due to the bill, millions of people across the country will lose health care, but the federal budget deficit is expected to increase by 3.4 tons by 2034.

Trump has brought Missouri, a Midwest state that has deviated sharply from the Democrats in the last three decades in the November vote. In Pemiscot County, census data show that more than a quarter of residents are below the poverty line and have a median income just over $40,000, he is the choice of 74% of voters, and Republican lawmakers representing the county have played a significant role in guiding his tax and spending bill through Congress.

Senator Josh Hawley Public advocacy “If Republicans want to be a working-class party (if we want to be a majority party), we must ignore the call to cut Medicaid and start making promises for the U.S. commitment to American workers,” opposition wrote in the New York Times. He finally supported the bill after including $50 billion in funding to help rural hospitals, but a few weeks later Legislation has been introduced That would abolish some of the cuts he just voted for.

“I want to see the stop of Medicaid reduction and rural hospitals get permanent funding,” the senator said.

Jason Smith’s area covers Pemiscot County and other areas in Southeast Missouri, overseeing the production of the measure as chairman of the House Roads and Means Committee and believes they will bring prosperity to rural areas across the state. Like others in the Republican Party, Medicaid cuts will eliminate “waste, fraud and abuse” and increase the efficiency of the program.

According to the Healthcare Quality and Payment Reform Policy Group, it is a gambling in a state where nine rural hospitals have been closed since 2015, including one county adjacent to Pemiscot and another 10 counties have 10 dangerous risks.

Missouri budget project ThinkTank estimates that the bill will give 170,000 health coverage for state residents, largely due to job requirements, which will be difficult to meet for Medicaid’s traditional tape, while the cap on provider taxes will cut $1.9 billion in the state’s Medicaid program.

“In the next five years, there will be some very tough conversations over the next five years, and I think health care in our area will look very different,” said Karen White, CEO of Highland Healthcare, Missouri. She predicts that 20% of patients will lose Medicaid coverage in 2030.

As the bill moves forward in Congress, she contacted the office of Smith, Hawley and Missouri Junior Senator Eric Schmitt, who voted for all the politicians she asked them to reconsider cutting Medicaid. She didn’t hear it.

“I love democracy. I like the fact that we as citizens can express our voices. They vote for the way they think they need to vote. Maybe… the bigger constituencies are different from theirs and mine, but I hear mine,” White said.

A spokesperson for Schmitt and Smith did not respond to a request for comment. In response to email questions, a spokesman for Hawley mentioned the legislation he introduced to partially stop Medicaid cuts.

Hayti Heights is on the hospital road where there are no businesses and deep puddles forming, potholes and ditches after each thunderstorm, there are routes on the road. Mayor Catrina Robinson plans to turn things around for her 500 or so residents, which involves bringing the water treatment plant back to service, the town’s main source of income. However, without the Pemiscot Memorial, this is unlikely to change.

“Half of the people who work in the hospital are my residents. So how will they pay the bills? How will they pay the water bills, how will they pay the bills, how will they pay the rent? That’s their income. That’s their income. What will they do?” Robinson said.

Trump’s bill does include a series of relief for working-class voters he broke into in the last election, including tax cuts and overtime pay and deductions for older people. It remains to be seen if any financial benefits these regulations have for Pemiscott County workers will outweigh the impact of Medicaid cuts on their health care system.

“The tax breaks prompted by the server and all of that, that won’t change the poverty level in our area,” said Loren Clifton, hospital executive director. “People who have lost their health insurance will definitely make things worse.”

Jobs can be found in county corn, wheat, soybean and rice fields, casinos in county town Caruthersville, and shipyards along the Mississippi coast. But green questions are whether these industries will be in trouble, and if the hospital is in trouble and brings it to the emergency room, which is often moving key patients elsewhere to stabilize critical patients.

“Our community can’t be without hospitals. Healthcare, employment, industry – it will destroy everything.”

The board is exploring partnerships with other companies to help keep the hospitals alive and has applied for the designation of the federal rural emergency hospital, which they believe will improve their reimbursement and win opportunities, although it will require them to give up other services that bring in revenue. For many leaders, the bet to keep hospitals open is personal.

“This is our home, born and raised, you never want to leave it. But I have a nine-year-old heart problem. Without a hospital, I won’t live safely here and I can take her to know if something is going on,” said Brittany Osborne, interim interim CEO of Pemiscot Memorial.

A sultry man in July, three county commissioners of Pimmy Scott, all Republicans gathered in a small conference room at Carruthersville Court and spoke about their determination to keep the hospital open.

“It’s 50-50 now,” Commissioner Mark Cartee said of the hospital’s chances of survival. “But as long as we have some money at the county bank, we’re going to stay open. We need health care. We have to be hospital.”

They are relatively optimistic about the possibility that Medicaid job requirements could harm the financial status of the facility.

“We have a guy here and I think he is still there.. “There’s so much fraud…it sounds like we’re in it.”

A few blocks away, Jim Brands, the owner of the county’s oldest Haydn Pharmacy, undoubtedly some people in the county have taken advantage of Medicaid. He also believes that fewer participants in the program mean less business to his pharmacy, which is more difficult overall.

“As long as we see this community, poverty, we have to get people to work. There are a lot of sound people who can choose not to do that,” he said.

“For me, there has to be a better way to eliminate fraud, rather than step on the toes of people who need it.”