At a recent media event sponsored by Virginia Organizing, Beth O’Connor, executive director of the Virginia Rural Health Association shared the following remarks. We are publishing them in full here because all of us in Pulaski County – insured or not, health care professionals or not – have a stake in our local economy and should be concerned when our elected representatives repeatedly choose to refuse federal dollars (paid for by Virginians) that could be used to support not only local individuals, but also our local institutions and overall economy.

Many people are unhappy with the Affordable Care Act for different reasons: Some wanted universal healthcare. Others thought a single-payer system would go too far. So a deal was struck: hospitals would agree to lower Medicare payments and in return, more of their patients would have insurance.

Unlike a business, a hospital has to accept anyone who walks into the emergency department, whether or not they are able to pay. If you are hungry and go to a grocery, but are unable to pay – you will not get food. But if you show up at a hospital, that facility is required by federal law to serve you anyway.

If too many people are unable to pay, the hospital will close. On October 1st, 2014 Lee Regional Medical Center closed. It is dead. The jobs from that facility are dead; the money it pumped into the local economy is dead.

Cause of death? The lack of Medicaid expansion.

At small rural hospitals the percentage of people who are unable to pay is high. For Lee Regional Medical Center that number was 12%; uninsured rates at other rural facilities in Virginia range from 10% to over 15%. Do you know of a business that could stay open if 15% of their customers did not pay the bill?

A few months ago – the hospital in Patrick County closed.

32 states have moved forward with Medicaid expansion, but Virginia is dragging its feet – and now two hospitals have died.

Loss of a hospital means the loss of jobs. Lee Regional Medical Center supported 190 FTEs. These are not low-paying, entry-level jobs. These are doctors, nurses, anesthesiologists, therapists.

Loss of a hospital means losing a pillar of the local economy. The hospital in Lee County, was the fourth largest employer in the area, it provided $11.5 million dollars annually in labor costs.

Make no mistake – people will die because these hospitals have closed. The average time for EMS to transport someone to emergency care from Patrick County has increased from 30 minutes to up to 3 hours.

If it can happen to one small community, it can happen to others. And while one failing town may not seem to matter in other parts of the state, once the dominos start to tumble, it will hurt everyone.

82 hospitals in rural America have closed since 2010. Two-thirds of them in states that have refused to expand Medicaid.

Remember that the Affordable Care Act is a federal program. Therefore, the people of Virginia are already paying for Medicaid expansion.

My taxes, your taxes, are being collected to support Medicaid expansion, but those dollars are going to Washington, DC, and not coming back to Virginia.

In September of 2010, Virginia had 24 small, rural hospitals. Now there are 22. How many more will close before we determine that Virginia’s money needs to stay in Virginia?