|
|
Welcome to a special midweek message from the North Dakota Democratic-NPL Insider, a newsletter that features regular updates about upcoming Dem-NPL events, legislative happenings, and news that affects North Dakotans!
|
|
|
|
|
|
Julie Fedorchak, John Hoeven, and Kevin Cramer all voted for this. Right now, Congressional Democrats are demanding Republicans stop the Medicaid cuts.
|
Call Fedorchak, Hoeven, and Cramer, and demand they stop the cuts! (202) 224-3121
|
|
|
One Big Beautiful Bill Act health-related changes can have a negative impact on rural North Dakota
|
The North Dakota Rural Health Association (NDRHA) represents and advocates for rural North Dakotans on a range of health issues. Federal health policy does not always work well in rural areas. Nationally, only 20 percent of Americans are classified as rural; nevertheless, rural populations are more reliant on federal health and social service programming. A higher percentage of rural residents receive Medicaid than urban. In North Dakota, 54% of the people using Medicaid are rural. In rural North Dakota, people have pride in their communities. They care about their neighbors. The people they meet at the clinic are the same people they sit next to at the basketball game, or at church, or visit with in the grocery store. Rural communities tend to be collaborative, creative and resilient. People band together for the good of the town. At the same time, rural areas have barriers to deal with that impact both health and health care.
|
One barrier is access to care, which includes physical remoteness and isolation, the distance between services and resources; financial insecurity such as higher rates of unemployment, poverty, and less health insurance; lower and less reliable payment to health care providers and facilities; and health workforce shortages and maldistribution.
|
A second barrier is “mortar and brick,” or the physical infrastructure of a community and a health system. The third barrier is technology, including broadband, which is essential for modern health systems. And a fourth barrier is economics, including maintaining a viable local economy providing good paying jobs and growth opportunities.
|
What happens in Washington, D.C., has an impact on us in our daily lives affecting family and friends. The recently passed One Big Beautiful Bill Act (OBBBA) is a massive federal policy change that impacts our health care system and even our personal health.
|
The OBBBA ushered in many health-related changes that can have a negative impact on rural North Dakota. This includes reducing access to care and contributing to poorer health outcomes. Over a 10-year period, OBBBA will cut Medicaid by $1 trillion nationally. This includes a projected $1.4 billion cut to North Dakota (source: North Dakota Legislative Council). The cause of reductions is related to a stronger work requirement. The new work requirement stipulation is not necessarily a bad idea; however, nationally, 67% of adult Medicaid recipients already work (72% in North Dakota). Another 20%-25% are either disabled/have medical issues preventing work or are family caregivers and not required to seek employment.
|
Nationally, the federal government estimates that 12-17 million would lose Medicaid coverage, primarily those in Medicaid Expansion. Out of the 105,000 North Dakota Medicaid recipients, upward of 18% or 19,000 would lose access in the state (Legislative Council). The reason for the reduction in the number of Medicaid participants is directly related to implementing the work, and especially the reporting requirement, the administrative function is needlessly burdensome – applying twice a year, reporting work data, online, monthly to prove they are working, dealing with cumbersome online systems and technology, making reapplication mistakes and/or administration burdens, having to wait to reapply, and added service costs/out-of-pocket expenses for those on Medicaid Expansion ($35 service fee). Nationally, about 40% receiving Medicaid Expansion are expected to lose access. With rural North Dakota’s high utilization of Medicaid, this will have a profound impact in rural areas for patients and health providers. Future policy needs to ensure that work requirements help as oppose to harming rural communities.
|
In addition to Medicaid, there are serious modifications to the ACA Marketplace, the federally supported health insurance option. About 45,000 North Dakotans have insurance through the Marketplace. The OBBBA eliminates the expanded tax credit that buys down the cost to the subscriber. This will increase premium costs, some as high as 75% for the 90% of North Dakotans who have their insurance through the Marketplace.
|
Other OBBBA concerns impacting health are cuts and changes to “safety net” programs such as Supplemental Nutrition Assistance Program (SNAP), home weatherization, fuel assistance and other services. This will negatively affect specific rural populations such as seniors, moms with children, veterans and people with disabilities.
|
We recognize that these changes not only affect rural citizens but also your local health system. The national projection is that over 300 rural hospitals will close, with North Dakota looking at projected three closures. Due to cutbacks in payment and in the number of people having insurance through Medicaid and/or the ACA Marketplace, rural hospitals and clinics will have to cut back services offered and will see staff and provider reductions.
|
As one North Dakota Critical Access Hospital CEO commented, “People will still get sick. They will come to our emergency room, and we will treat them. But there will not be any funding to cover the cost, it will go to our bad debt. Also, emergency care is not primary care, there will be no continuation of prevention, wellness, and disease management. People will just get sicker.”
|
|
We encourage you to discuss your concerns with your local providers. NDRHA will stay committed to improving health and access to care for rural North Dakotans.
|
|
|
|
|
|
|
|
|
The Century Club supports our year-round work to build party infrastructure supporting candidate recruitment, local district and regional leadership, issue-based education, and tools for Dem-NPL success.
|
|
|
|
|
Help us elect great Democrats up and down the ballot!
|
|
|
|
|
The North Dakota Democratic-NPL is launching a new grassroots program called “Neighbor to Neighbor” where volunteers will connect with voters in your community to elect Democrats up and down the ballot. As a volunteer, you will be responsible for connecting with voters in 25 homes in your neighborhood or friends and family to help elect Democrats up and down the ballot about 3-4 times this year.
|
|
|
|
Grassroots organizers are the lifeblood of the Dem-NPL! Sign up to volunteer with the Dem-NPL!
|
|
|
|
|
|
|
|
|
