Copyright keenesentinel
The continuing federal government shutdown on top of the administration’s funding cutbacks has rural health-care advocates alarmed, not just because of what they know will happen but what they don’t know. “We’re at this risky point, there are large things that can happen and we’re ill-prepared to handle them at this moment,” said Christin D’Ovidio of Putney Consulting during a webinar Tuesday sponsored by Protect Our Care New Hampshire, a non-profit advocacy group. “Right now there are a lot of unknowns,” said Jayme Simões, chair of Protect Our Care. “This is not just a political standoff — it’s a direct threat to health and stability of families across our state.” The webinar is the latest sign of concern about the ongoing federal government shutdown’s effect on rural health care on top of other federal cutbacks. The shutdown has already reduced help during open enrollment for Medicare, which began Oct. 15, at a time when premiums are rising and options are changing. More worrisome is the possibility that Head Start, the preschool program, and SNAP, food assistance for low-income families, could be curtailed if the shutdown continues into November. Both depend on annual Congressional appropriations. State Rep. Janet Lucas, a Campton Democrat, said a woman ended up in the hospital because of difficulties getting transportation to increasingly distant health-care facilities in Grafton County. “New Hampshire has been defunding some very important programs for so long, it cuts to the bone and beyond,” she said. “We’re in the space where new cuts may end the programs that save money.” The current federal government shutdown is largely about the cost of premiums for health care plans that people buy on the Affordable Care Act marketplaces. Enhanced tax credits for these premiums expire at the end of the year, leading to predictions that premiums could almost double for many people. More than 70,000 people in New Hampshire used the tax credits to help pay for the ACA insurance last year. Democrats in the U.S. Senate have refused to vote for the Republicans’ short-term funding bill, which did not include an extension of these enhanced tax credits. “We are looking at a degradation of the health system, especially in the northern counties, with the loss of the ACA program,” said Lucas. “How, for example, will a woman be able to obtain normal routine prenatal care if she’s got to find transportation requiring a two-or three-hour drive … The community as a whole will have to absorb the costs that aren’t covered when providers aren’t reimbursed.” The lack of support services, she said, means patients are more likely to “be presented to the emergency room, to be much more frail, sicker, and eventually cost us all more. That’s a problem that’s exacerbated in the rural areas of the state.”
