His opponent, Democrat
And just about everyone running for office has a theory about how the closure of
In the months leading up to Tuesday's election, candidates have argued about everything from a Space Force to whether to hold a televised debate. But one theme has remained constant: rural health care and how to fix it.
"Virtually every Democrat running is talking about expanding Medicaid, and
In a survey released earlier this year by the
For much of the campaign, health care was a ten-thousand-foot policy issue, with candidates sometimes struggling to connect stories of personal hardship to policy decisions about insurance.
Then RMC Jacksonville closed.
Closing, and expanding
"Problems seem to be far away until they're in your own home," Hagan said in a meeting with Star editors earlier this year. "Right now, in the state of
Republican incumbents sometimes bristle at the idea that the hospital's closure could be laid at their feet. State
"We had our hands full," said
Tanner in 2016 opened a hospital in rural
The hospital is still operating in the red, Howard said. Until the
Covering uninsured patients is part of the problem, she said. But it's difficult to say whether Medicaid expansion alone would have saved any single hospital from closure.
"We know that Medicaid expansion is the one biggest thing the state can do to help the survival of our hospitals," she said.
Howard identified another problem facing those hospitals: the Medicare Wage Index, a formula which determines how much the federal government reimburses hospitals for care for patients covered by federal programs. The formula -- intended to reflect the higher cost-of-living in major cities -- now pays urban hospitals much more for performing the same procedures, she said.
"It's piling on and piling on to a fragile system," she said.
The wage index may be one reason
Fixing the wage index problem may be the one health care issue candidates agree on across party lines. In a speech in
"These are not other states' dollars," Jones said. "These are your dollars."
Jones said he and other lawmakers were in talks with
"That is the number one thing," said incumbent
Rogers said he believed the formula could be changed administratively, without legislation being passed.
In an interview last month, Rogers said a fix to the problem would take legislation at the national level. In remarks after the Jones speech last week, Rogers said he believed the wage index could be changed by administrative action.
Not waiting for answers
Even if rural health care's financial problems get fixed, no one on the ballot is arguing that RMC Jacksonville or any of the state's other closed hospitals will be reopened. Candidates on both sides say they'd like to see some sort of clinic open on the hospital site.
Some candidates are looking for new policies to fill the gaps in a world with fewer hospitals. Democratic state
Hagan, the Democratic Congressional candidate, has advocated for more federal support for birthing centers -- lower-cost maternity clinics where women are attended mostly by midwives -- to better serve women who otherwise have a long drive to an obstetrician.
There are no such birthing centers in
"Right now, about a third of birth centers serve a rural population," Bauer said. "It is an option to fill a gap."
There are plenty of unknowns that could make the health care conversation still more complicated. Hospitals for years have been bracing for the end of
There's also the chance that the Affordable Care Act could be repealed, though what would replace it is still unclear. Attempts to repeal and replace have failed in recent years, even with
Polls open at
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