John Daley, Colorado Public Radio
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. Big, round fields of crops, interspersed with native shrubs, give it a really feel of bucolic quiet.
But amid the stark magnificence in one of many state’s most productive agricultural regions, there was a way of unease among the many neighborhood’s leaders as Congress debated a funds invoice that might radically reshape Medicaid, the government health program for low-income individuals.
“I’m trying to be worried and optimistic,” mentioned Konnie Martin, CEO of San Luis Valley Health in Alamosa, Colorado, the hub for well being care companies for 50,000 individuals in six rural counties.
Martin mentioned 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 purple, Martin mentioned.
The well being system’s annual funds is $140 million, and Medicaid income makes up practically a 3rd of that, based on Shane Mortensen, chief monetary officer for SLV Health.
The working margin is razor-thin, so federal cuts to Medicaid may drive troublesome cuts at SLV. “It will be devastating to us,” Mortensen mentioned.
The region is among the state’s poorest. In Alamosa County, 2 in 5 residents are enrolled in Health First Colorado, the state’s Medicaid program.
It’s a lifeline, particularly for individuals who wouldn’t in any other case have quick access to well being care. That contains 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,” mentioned Julianna Mascarenas, a mom of six. She mentioned 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.
Across the state, Medicaid covers 1 in 5 Coloradans, more than a million people.
That contains 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 Chance Padilla mentioned, 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 mentioned. “These kids require a lot of medical intervention.”
Chris Padilla, Chance’s husband, mentioned: “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.”
Staff and directors at SLV Health ponder whether federal cuts will make it onerous for the system to maintain its most cancers heart operating.
“It could be pretty dramatically affected,” mentioned 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 keep open. About 85% of the hospital’s labor and supply sufferers are lined by Medicaid, Hernandez mentioned.
“If we don’t have obstetric services here, then where are they going to go?” mentioned 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 lately pressured to consider that chance after giving delivery to her fourth little one.
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 mentioned. “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.”
Providing Health Care — And Jobs
With 750 employees, the well being system is the valley’s largest employer. Clint Sowards, a main care doctor, mentioned having much less Medicaid funds will make it more durable to draw the subsequent era of docs, nurses, and different well being care employees.
Certain medical specialties would possibly now not be obtainable, Sowards mentioned. “People will have to leave. They will have to leave the San Luis Valley.”
Kristina Steinberg is a household medication doctor with Valley-Wide Health Systems, a community of small clinics serving hundreds within the area. She mentioned Medicaid covers most nursing dwelling residents within the space. “If seniors lost access to Medicaid for long-term care, we would lose some nursing homes,” she mentioned. “They would consolidate.”
Audrey Reich Loy, a licensed social employee and SLV Health’s director of packages, mentioned 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 mentioned. “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.”
Seeking More Efficiency
Republicans in Congress who pushed for the massive spending and tax legislation, which estimates recommend will lead to massive 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 mentioned.
He mentioned Medicaid cuts may give President Trump’s supporters second ideas, however he famous that politics is a delicate matter that he principally doesn’t talk about with sufferers.
Sowards mentioned he understands that some individuals consider the Medicaid system is ailing and expensive. But he mentioned he has grave doubts in regards to the proposed treatment.
“Losing Medicaid would have drastic repercussions that we can’t foresee,” Sowards mentioned.
Cuts Would Create Ripple Effect
SLV Health’s regional financial impression is more than $100 million a year, with Medicaid accounting for a significant a part of that, Martin mentioned.
Any Medicaid cuts would hit the well being system onerous, however they might additionally have an effect on small companies and their workers. The area is feeling financial stress from different adjustments, like current cuts the Trump administration made to the federal workforce.
The San Luis Valley is dwelling to the Monte Vista National Wildlife Refuge, Great Sand Dunes National Park, and different federally managed lands.
Joe Martinez, president of San Luis Valley Federal Bank, mentioned that lately 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 mentioned his message about Medicaid cuts was easy: “It can have a devastating economic impact.” Coleman put collectively a protracted record of doable troubles: More persistent illness and better mortality charges. Longer wait occasions 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 mentioned. “And I don’t think people are getting it.”
This article is from a partnership that features CPR News, NPR and KFF Health News.
