'Don't know how we will survive': Medicaid cuts could put this group of mothers in peril
WASHINGTON – Meghan Hullinger credits her life, and that of her now-7-year-old son, to Medicaid. The 42-year-old community engagement specialist for a nonprofit said she became close to septic while pregnant with her third child, and that without the government-funded health insurance program, she would not have been able to afford live-saving care. "That would have been an astronomical cost," Hullinger said of her emergency room visits, hospital stay and procedure. If not for Medicaid, "I'm almost positive I would have died." Now, Medicaid is on the chopping block. The health care program that insures more than 70 million low-income and disabled Americans has been caught in the crosshairs of negotiations, as Republicans in Congress hash out a major overhaul on government spending in order to implement PresidentDonald Trump'stax cuts and other legislative priorities. At least 7.7 million individuals could end up without coverage over the next decade under Republicans' current plan, according to an estimate by the nonpartisan Congressional Budget Office. Among those most vulnerable to Medicaid reform, experts told USA TODAY, are women like Hullinger who are giving birth and raising children in rural areas, where maternal services are often already in short supply. And with many rural hospitals teetering on the knife's edge of financial stability, any loss of funds from decreased Medicaid spending could push some facilities towards closure and make care access more difficult for all patients, regardless of their provider. "It threatens the abilities of rural communities to grow and thrive," said Joan Alker, executive director of the Center for Children and Families at Georgetown University. Suffering from extreme nauseousness and urinating blood, Hullinger went to see her OBGYN, located a ninety-minute drive from her 1,000-person town of Marlinton, West Virginia. Later that week, still struggling to keep food down, she visited the emergency room and sat for a round of blood work. Twenty-four hours after that, Hullinger said her partner found her at home on the couch, pale and sweating, and he demanded she return to the ER. This time, she was sent by ambulance to a larger hospital three counties and three hours over in the state's capital city. Doctors at Charleston Area Medical Center diagnosed her with pancreatitis and said her gallbladder would need to be removed, following a week of IV fluids. What would have cost thousands – including her initial OBGYN appointment, the hospital stay and procedure – she said was all covered by Medicaid. As was the birth of her son, Nathan, four months later. Pocahontas County, where Hullinger lives, is "very, very rural," she said. "To put it in perspective, we have two stoplights in the entire county." The county of less than 8,000 people is alsoprimarily servedby one rural hospital with limited services. "It's already very difficult in the best of circumstances for moms to deliver babies, for pregnant moms to stay healthy," said Hullinger, a mother of four. Adding onto that any reductions in Medicaid, she said, would be "devastating." In U.S. cities, around 1 in 5 women between the ages of 19 and 44 rely on Medicaid for health insurance. In rural areas, that number can jump closer to 1 in 4, according to anew reportby Georgetown University's Center for Children and Families. The program has been a "lifeline" for Victoria Fuller, 35, of Sierra Vista, Arizona. The mother of five said Medicaid covered her prenatal and post-partum visits, as well as the additional medical care needed when she was diagnosed with gestational diabetes in her third pregnancy. "For me personally, losing Medicaid during my third pregnancy would have meant going without the care I needed," Fuller said, "which could have led to serious complications for both me and my baby." Medicaid covers almost half of all births in rural America, compared to 40% of those in metropolitan areas, Georgetown University's report found. "Medicaid cuts would be especially devastating for rural communities," Alker of Georgetown said, "because they're already suffering from a sharp decline in the availability of obstetric services and labor and delivery services." In Iowa, where registered nurse Abby Butler lives, 62 out of the state's 77 rural counties do not have a practicing OBGYN, according toa studyby Common Sense Institute Iowa last August. "Those are already people who are lacking providers," Butler, 26, said. Plus, Butler said, "Rural hospitals really rely on Medicaid to function." Medicaid accounted for almost 20% of hospital spending across the board in 2023, according to the health policynonprofit KFF. Meanwhile, about half of all rural hospitals are operating withnegative margins. Butler, currently in the second trimester of pregnancy with her second child, said the hospital where she works in Dubuque, Iowa, sees many patients brought in from neighboring rural care centers. The loss of Medicaid funds by any measure, she said, could devastate some facilities, forcing them to close and leaving entire areas stranded for care. "When you're pregnant, you have to go and see the doctor a lot," Butler said. "Towards the end, you're going there once a week. So imagine having to travel once a week an hour; a lot of people would just end up not going to see their doctor." "Or," she added, "if they had any issues, that long travel to a hospital ... they could lose the baby or they could die on their way." Mississippi state Rep. Timaka James-Jones worries now that shrinking Medicaid access could mean more stories like that of her niece, Harmony Ball-Stribling. The evening of July 4, 2021, Byron Stribling rushed to get his wife, pregnant with their first child, to the nearest hospital, about 30 miles away. Harmony and her unborn child, who the couple had named Harper, died before they could reach the hospital, four days before her scheduled due date. "We're not talking dollars and cents," James-Jones said. "At the end of the day, now we're talking about lives, and people are dying. People are truly dying because there is no health care in some places." Republican leaders in Congress are racing to finalize a massive spending package before the end of summer. In order to finance the ambitious overhaul, House Speaker Mike Johnson, R-Louisiana, has promised to tighten the federal purse strings by trillions and directed various committees to come up with the difference. The House Energy and Commerce Committee was tasked with finding $880 billion in savings from programs under their purview. Since Trump expressly ruled out changes to Medicare, which provides health care coverage for the elderly, focus turned then to Medicaid. In a party-line vote on May 14 thatfollowed a marathon meeting, members of the GOP-led committee advanced several rollbacks to Medicaid coverage, including work requirements. People who are pregnant or receiving care post-partumare among those exemptfrom this employment requisite. The new provisions avoided some of the more drastic cuts lawmakers had proposed, such as lowering the federal match rates with states. Republicans in the Energy and Commerce Committee said the changes they did back are intended to cut waste and fraud in order to protect Medicaid for those who really need it. "Medicaid was created to provide health care for Americans who otherwise could not support themselves, but Democrats expanded the program far beyond this core mission," Chair Brett Guthrie, R-Kentucky, said during the committee's meeting that began on May 13. Democrats in Congress and across the country have pushed back, saying that cuts of any size could still have consequences for Americans seeking care. The same year that Harmony Ball-Stribling died, Mississippi had the highest maternal mortality rateof any state. The Magnolia State, where over half the population livesin rural communities, is one of 10 states that have yet to expand Medicaid. "The federal government is talking about cutting more − I just don't know how we will survive," James-Jones said. Contributing: Riley Beggin This article originally appeared on USA TODAY:Medicaid cuts could put this group of mothers in peril
'Don't know how we will survive': Medicaid cuts could put this group of mothers in peril WASHINGTON – Meghan Hullinger credits h...
