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Rural Hospitals Fight to Block $16B in Federal Cuts

Alexandra Wilson Pecci, for HealthLeaders Media, July 27, 2011

As political power players in Washington continue to bicker and wrangle over the country's debt ceiling crisis, rural healthcare providers are up in arms over $16 billion in proposed cuts to rural hospitals and frontier America.

Included in a list of proposed reductions is $14 billion over 10 years to "reform rural hospitals" and $2 billion over 10 years to "repeal Frontier State Adjustments." Whether those cuts are part of current debt ceiling negotiations is "the several-billion-dollar question," Maggie Elehwany, vice president of government affairs and policy at the National Rural Health Association (NRHA), said in an interview.

She says the documents, which have been attributed by some to Congressman Eric Cantor (R., VA), the minority whip, were leaked and that no other details about the cuts are known.

"We are operating on a lot of unknowns out there. But," Elehwany said, "We really need to go loud on it, so to speak."

Even though information about the cuts was revealed a couple of weeks ago, NRHA is still concerned that these deep cuts may still be part of current debt ceiling negotiations, especially since a Congressional Budget Office [CBO] report issued in March suggests that eliminating the Critical Access Hospital, Sole Community Hospital, and Medicare Dependent Hospital programs would "reduce federal outlays by $23 billion over the 2012–2016 period."

"We're sure hoping that that [CBO report] didn't lead to the fodder for these discussions in rural healthcare," Elehwany said, adding that they can guess that the cuts might come from cost-based reimbursement. "It would all be a guessing game. But we have folks that are trying to do the math on all possible scenarios."

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