Our health care

Should the so-called “One Big Beautiful Bill” passed by the U.S. House last week and supported by Eighth District congressman Pete Stauber ultimately become law, the quality health care that residents of our region depend upon could well become a thing of the past.
Area clinics operated by Scenic Rivers and rural hospitals, like those in Cook, Ely, and International Falls, will be forced to cut staff and services, and some facilities could even close.
While Stauber and other Republicans who backed this horrific legislation claim that they are eliminating waste, fraud, and abuse in Medicaid, the changes their bill makes to the program does nothing to address those issues. The hundreds of billions of dollars they hope to wring out of Medicaid over the next decade will come from throwing millions of Americans off the program by burying them in paperwork. The Republicans call it a “work requirement” but the reality is that most of the people who will lose their Medicaid coverage are working, many are working two jobs. They will simply struggle under the blizzard of forms they’ll be expected to fill out multiple times a year to hold on to their coverage. Some states have already experimented with work requirements, so we know how this ends: no additional people in the workforce, just lots more Americans going without health care.
That’s actually the plan. Throwing people off Medicaid is how the GOP bill finds savings to at least partially cover the cost of their budget-busting tax cuts for the wealthy. Denying health care to working stiffs to fund tax cuts for the rich – that’s the Republican’s definition of “One Big Beautiful Bill.”
But wait, there’s more. While the GOP bill extends tax cuts focused on high earners, it failed to extend the enhanced advanced premium tax credits that helped make private insurance more affordable on the Obamacare marketplaces, like MNsure. The nonpartisan Congressional Budget Office projects that as a result of these two changes, 13.7 million Americans will have lost their health insurance within the decade because it’s no longer affordable. According to an analysis by the Kaiser Family Foundation, that is likely to include about 180,000 Minnesotans.
These changes will hit rural residents hardest, since they are the ones most likely to be on government health coverage. In St. Louis County alone, that’s likely to amount to at least 15,000 residents who will lose their insurance.
But these cuts threaten to impact all of us in northern St. Louis County. Currently, those 15,000 county residents are making use of their coverage to meet their health care needs, and those services are being paid for by Medicaid or the private insurance they’ve obtained through MNsure. As that coverage disappears, those individuals will either do without health care or the clinics and hospitals they enter will end up eating the cost of that care in most cases. Either way, that puts the finances of our local clinics and hospitals at risk. As anyone who has followed the status of rural health care knows, these facilities are already operating on shoestring margins. Most don’t have fat in the budget that can be easily trimmed. In many cases, operational costs are fixed, and staff cuts can only bring so much savings.
While we might have been able to expect the state of Minnesota to ride to the rescue in the past, states are dealing with financial hits from other federal funding cuts at the same time. That will make it increasingly difficult, if not impossible, for the state to make up these funding shortfalls.
It’s worth noting that passage of the Affordable Care Act, otherwise known as Obamacare, made it possible for Scenic Rivers to open new clinics (including the clinic in Tower) and hire additional doctors precisely because more of their patients had insurance coverage that could pay for the services they provided. While the GOP failed to repeal Obamacare during the first Trump administration, they’re now using backdoor methods to essentially achieve the same goal. And that is going to have severe repercussions for the ability of rural residents to access health care in the future, especially the primary services that so many of us rely on day-to-day.
We know that the Trump administration and Republicans in Congress will do nothing to save rural hospitals and clinics, unless the people who rely on these facilities stand up and fight their efforts. Republicans can’t claim these changes are needed to balance the budget. They’ve already gave that game away with their tax cut plan for the big donors.
As we have noted on this page time and again, politics always comes down to priorities. And Republicans like Pete Stauber have made their priorities crystal clear.