'Devastating for our rural communities': Gov. Cooper highlights hospital closures as legislature delays on state budget

The hospital in Martin County, an agricultural community in eastern North Carolina between Greenville and the Outer Banks, closed down this month. It was the 12th rural hospital around the state to shut its doors since 2005.

This week Gov. Roy Cooper will host a community discussion in the area followed by others in Yadkin and Richmond counties, which have also been hit by hospital closures in recent years.

Hospitals must still serve people who come to the emergency room for treatment even if they can't pay and don't have insurance. That can be a financial issue particularly in poorer, more rural counties where as many as one in every four or five people is uninsured — and it's an issue supporters of Medicaid expansion hope that program will help with immensely.

In a press release announcing the upcoming meetings in Martin, Richmond and Yadkin counties Cooper's office said seven rural hospitals in North Carolina have closed down since the state could've first approved Medicaid expansion in 2014.

"The continued failure to pass a budget and start Medicaid expansion is devastating for our rural communities who have been waiting for years for this support and cannot afford any more hospital closures,” Cooper said. “Whether it’s drawing down federal money to battle the opioid epidemic or just keeping the hospital doors open, Medicaid expansion is critical to supporting rural North Carolina, and we cannot delay any longer.”

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Republican lawmakers had long resisted Medicaid expansion, but this year top GOP leaders changed their mind and the legislature approved it with broad bipartisan support.

But it still has yet to go into effect, since the law tied expansion to the state budget — which is now two months overdue, and likely at least another month away from becoming law.

Medicaid expansion would give health care coverage to hundreds of thousands of North Carolinians, funded almost entirely by the federal government. It would bring in an estimated $500 million per month — billions of extra dollars a year flowing into the state's hospitals, doctors offices, pharmacies and other health care providers.

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That proposal has also been pitched as a way to revitalize hard-hit rural communities, by writing the legislation so the casinos would locate there instead of in the state's main cities.

Any budget delays beyond the end of August, however, mean the state will miss a key federal deadline for Medicaid — likely pushing expansion back until December instead of the original proposed October start date.