The ongoing federal government shutdown is raising significant concerns among rural health advocates, who fear that the impact could severely compromise healthcare services in rural areas. During a webinar on October 17, 2023, hosted by Protect Our Care New Hampshire, experts highlighted the risks associated with both the shutdown and prior funding cuts.
Christin D’Ovidio of Putney Consulting stressed the uncertainty surrounding the situation, stating, “We’re at this risky point, there are large things that can happen and we’re ill-prepared to handle them at this moment.” Jayme Simões, chair of Protect Our Care, echoed these sentiments, declaring that the shutdown poses a “direct threat to health and stability of families across our state.”
As the federal government remains closed, advocates are particularly worried about the implications for critical programs like Medicare, which began its open enrollment period on October 15. The shutdown has already hindered assistance for those navigating changes in premiums and coverage options, leading to heightened anxiety among residents.
The potential for further disruptions looms large, particularly regarding programs such as Head Start, which provides preschool education, and the Supplemental Nutrition Assistance Program (SNAP) for low-income families. Both programs rely on annual appropriations from Congress, placing them at risk if the shutdown continues into November.
State Representative Janet Lucas, a Democrat from Campton, illustrated the human cost of these funding cuts. She recounted a troubling incident involving a woman who required hospitalization due to transportation issues in accessing healthcare facilities in increasingly remote areas of Grafton County. “New Hampshire has been defunding some very important programs for so long, it cuts to the bone and beyond,” Lucas noted.
The current shutdown is largely tied to disputes over the costs of premiums for health plans purchased through the Affordable Care Act (ACA) marketplaces. Enhanced tax credits that help subsidize these premiums are set to expire at the end of the year, leading to predictions that costs could nearly double for many individuals. Last year, over 70,000 residents in New Hampshire utilized these tax credits to afford ACA insurance.
Democratic senators have refused to support a short-term funding bill proposed by Republicans, which did not include an extension of enhanced tax credits. Lucas warned that the absence of these credits could lead to a “degradation of the health system, especially in the northern counties.” She raised concerns about how expectant mothers might access routine prenatal care if they face lengthy travel times to healthcare facilities.
The lack of support services means that many patients may eventually require emergency care, presenting with more severe health issues that are costlier to manage. “The community as a whole will have to absorb the costs that aren’t covered when providers aren’t reimbursed,” Lucas explained.
The situation remains precarious, as advocates continue to call for urgent action to address the intertwined challenges posed by the federal shutdown and ongoing funding cuts. The potential consequences for rural health care could be profound, affecting not only access to services but also the overall health and well-being of vulnerable populations across New Hampshire.
