Published on July 25, 2014 in The Public News Service. 

By Dan Heyman

RICHMOND, Va. – A small-town mayor walking though Virginia will reach Washington, D.C., on Monday, carrying the message that rural hospitals need Medicaid expansion to survive.

Adam O’Neal, the Republican mayor of Belhaven, N.C., is walking from his hometown to the nation’s capital – 540,000 steps, as he puts it – to drive home the impact of the closing of his town’s rural hospital. He said the facility would have been financially stronger had the state expanded Medicaid, and added that he’s found similar views along his route.

“We’ve had people invite us in their house for glasses of ice water,” he said. “Most of the people, of course, have been in rural communities, and they’re all afraid that they could be deprived of their health care in the future. This is not just a Belhaven issue, this is a national issue.”

The state General Assembly has refused to expand Medicaid for Virginia. Lawmakers will take the issue back up in September.

Rural hospitals “live close to the red line,” said Beth O’Connor, executive director of the Virginia Rural Health Association. Nationwide, she said, they average only 1 percent to 4 percent profit a year, but still have a huge burden in terms of treating patients who can’t afford to pay.

As many as one in five of the patients at Virginia’s rural hospitals gets uncompensated or charity care, O’Connor said, describing it as a serious burden for health-care facilities.

“If you are hungry and you go to a grocery store and you don’t have money, you’re not going to get food,” she said. “But if you walk into the hospital and you need care, and don’t have insurance and don’t have any money, they’re going to have to pay for you anyway.”

Critics of Obamacare say they don’t want to see government-funded health services expand, but unless more people get coverage somehow, O’Neal said, the rural hospitals won’t be viable.

“Many of them struggle each year to break even,” he said. “They depend on foundations and charitable gifts. So I don’t think anybody can argue that Medicaid expansion wouldn’t help rural hospitals. They struggle anyway.”

When he arrives in Washington, O’Neal said, he hopes to meet with the president, the U.S. Attorney General or the head of the Department of Health and Human Services.

O’Neal can be reached on Twitter at @MayorONeal or on at saveourhospital.org/walk.