August 19, 2025
Around the nation, rural hospitals will shut, and the empty cities will replicate the quiet halls the place medical doctors and nurses as soon as rushed to heal.
A decade in the past, when the Republican-led Montana legislature first handed Medicaid growth, I traveled to just about each one among our state’s rural hospitals upfront of our legislative consultation. I nonetheless be mindful a the town corridor assembly in Choteau, which has a inhabitants of simply 1,700 other folks. The health facility administrator shared that 43 % of the folk strolling in the course of the health facility’s doorways lacked insurance coverage; the chair of the County Fee informed the ones attending that in the event that they misplaced their health facility, they might lose town.
Rapid-forward to 2025. There at the moment are much more Republicans in our state legislature, but Medicaid’s reauthorization handed this yr by means of better margins. The fee-shifting of uncompensated care, the place the ones folks with insurance coverage duvet the prices of the ones with out—generally on the emergency room, the place it’s costliest—has considerably diminished. Preventive care, together with breast and colon most cancers screening and diabetes and high blood pressure remedy, continues to deal with well being issues on the entrance finish, quite than when it’s already too past due.
And whilst over 100 rural hospitals have close their doorways within the final decade, now not a unmarried one close down in Montana.
But, simply prior to the Fourth of July, as Congress headed into recess, DC Republicans voted to undo all of that onerous paintings. Now they’re house for the summer time, dealing with the very communities whose hospitals and healthcare they only voted to position in peril.
Republicans voted to kick hardworking Montanans off Medicaid. They voted to threaten the agricultural hospitals our communities depend on and to make healthcare dearer and not more obtainable.
In brief, Republicans voted to make our healthcare worse.
Present Factor
Senator Steve Daines defended his vote on Fox Information, saying, “We’ve were given to take able-bodied men who’re laying [sic] at the couches at house and get them again to paintings and rancid of Medicaid.”
The issue is, the ones people don’t exist in my state. In line with the Montana Healthcare Basis, 94 % of Montana adults on Medicaid are hired, disabled, caregivers, or scholars. The rest 6 % of working-age adults comes out to only underneath 9,000 other folks. Even though all 9,000 of the ones other folks had been simply “laying on couches”—and they don’t seem to be—Daines nonetheless voted to remove medical insurance from an estimated 31,000 other folks, greater than thrice the selection of unemployed adults on Medicaid.
And make no mistake, what hurts one among us in Montana hurts all folks. If our neighbors lose their medical insurance, all of us would possibly lose our hospitals
In line with one research, the Medicaid cuts will value Montana hospitals greater than $2.2 billion over the following 10 years, cash they are able to’t come up with the money for to lose.
When rural hospitals shut, there aren’t any possible choices for our citizens. They have got to force additional or now not get care in any respect. On best of that, the health facility is regularly the most important employer in a neighborhood, and the ones hospitals supply good-paying jobs, from nurses to medical doctors to upkeep team of workers. When the hospitals go away, Montanans will have to observe, forcing them to choose from their households within sight and the careers they love. In fact, this gained’t be restricted to Montana—those identical scenes will play out in each state around the nation.
Will Republicans pay on the poll field for making healthcare worse? They no doubt may just—KFF discovered that a majority of adults national adversarial the invoice after listening to it will cut back investment for native hospitals. Most likely unsurprisingly, Democrats and independents adversarial the invoice even prior to being informed it will harm hospitals, with 85 % and 71 % respectively protecting negative perspectives. Alternatively, non-MAGA Republicans additionally adversarial the invoice, with 51 % having negative perspectives, expanding to 64 % negative after listening to that it harm hospitals like those we’ve been preventing to give protection to right here in Montana. Even self-identified MAGA citizens couldn’t abdomen the wear to native hospitals, shifting from 78 % favorable to 55 % negative, a devastating indictment from Trump’s maximum devoted supporters.
Even the Republican politicians ramming it thru know how indignant their constituents are going to get. They wrote the regulation to verify the worst affects gained’t land till after the midterm elections. They added a fund to enhance rural hospitals for 5 years. They added extra bureaucracy and bureaucratic purple tape to Medicaid, however had it get started in December 2026, a month after the mud settles from the midterm elections. Because the outdated announcing is going, “You’ll be able to put lipstick on a pig, however it’s nonetheless a pig.”
Those Republican-led assaults may just lend a hand flip states like Montana again to pink—and even forged blue—however Democrats want to get started their messaging now, and so they want to stay it going. Democrats want to make certain that each voter is aware of why their health facility might shut down. Each voter wishes to grasp why their sister, brother, aunt, or cousin needed to transfer around the state to stay operating as a nurse practitioner. Each voter wishes to grasp why their neighbor do away with their healthcare till it used to be too past due.
Around the nation, citizens want to know the why: This wasn’t about being cautious stewards of your hard earned tax bucks—if that used to be the case, they wouldn’t have added some other $3 trillion to the federal debt. Republicans voted in opposition to our healthcare, and so they did it so they may give a bit more cash to the wealthiest amongst us.
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I am hoping the following time I consult with Choteau the health facility remains to be there. I be mindful how its other folks reacted to the chair of the County Fee’s caution—if we lose the health facility, we lose town.
Montana doesn’t want any longer rural ghost cities, however that’s what Republicans voted for. Around the nation, rural hospitals will shut, and the empty cities will replicate the quiet halls the place medical doctors and nurses as soon as rushed to heal.
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