Franconia, New Hampshire — The closing of a health center in rural New Hampshire has raised concerns that expected cuts to Medicaid have already taken their toll.
Last month, Ammonosuc Community Health Services in Franconia, a town of about 1,000 people, Closed forever.
Ammonosuc officials and a Democratic state senator blamed Medicaid cuts for the closure of the facility, which served 1,400 patients from Franconia, Easton, Lincoln and Sugar Hill. These are all small communities around the White Mountains, and their patients are usually older and sicker than in other parts of the state.
The Franconia Center’s closure reflects its financial difficulties Community health centers And rural health care systems more broadly amid Medicaid cuts and alarming spikes in health insurance prices. the Government shutdownwhich ended last week, was prompted by Democrats’ demand to extend the tax credits, which ensure low- and moderate-income people can afford health insurance through the Affordable Care Act, or ACA.
More than 100 hospitals have closed over the past decade, according to the Center for Healthcare Quality and Payment Reform, a policy and advocacy group, and more than 700 more are at risk of closing. HealthFirst Family Care Center, a facility in Canaan, New Hampshire, also announced that it will close its doors at the end of October due in part to “changes in Medicaid reimbursement and federal funding” for these facilities.
On average, federally funded community health centers, like the one in Franconia, are losing money, relying heavily on cash reserves, making service changes, and sometimes closing sites to stay afloat, NACHC found. According to the association, nearly half have cash on hand for less than 90 days. The future is even bleaker as at least 2 million patients at community health centers are expected to lose Medicaid coverage by 2034, and another 2 million newly uninsured will shift to care centers.
Ed Chanchala, CEO of Ammonosuc, said Medicaid cuts are to blame for the closing of the Franconia center.
Chanshala operates a network of five health centers in New Hampshire that relies on more than $2 million in federal funding — out of a budget of $12 million. He faced a $500,000 shortfall due to the cutbacks and realized that closing Franconia would save about half that amount. It was also the only facility where they rented space.
“We have no other choice,” Chanshala said, adding that the closure would save $250,000. Finding additional reductions is difficult, given that the centers serve anyone below 200% of federal poverty levels, he said. If additional services are cut, Chinchala fears that some patients will end up in the hospital emergency room or “stop participating in the health care period.”
Susan Bushby, a 70-year-old housekeeper, spoke of how much she loved the staff and was afraid to go to a new health centre. She wouldn’t know her way around a larger facility and wouldn’t have the same relationship with the people there.
“I was very upset. I was absolutely angry,” said Bushby, who cried as she discussed the challenges of starting over at a new health center. “I really like it there. I don’t know, I’m really going to miss it. It’s very hard for me to explain, but it’s going to be sad.”
Marsha Luce, whose family moved from the Washington, D.C., area in 2000, is particularly concerned about the impact on her 72-year-old husband, a former volunteer firefighter who had his left ear and part of his jaw removed because of cancer. He also suffers from heart and memory problems.
She worries about the long waits to see his doctor and the loss of relationships built up over decades in Franconia.
“It’s going to be difficult,” she said. “But it’s a relationship that we’ll miss. It’s a relationship where you can talk to people and tell them something and then say, yeah, well, I got cancer. Oh, let’s see. Oh, yeah. That’s in your chart. Do you know what I mean?”