The closing of a hospital in rural North Carolina may not seem like a huge deal—on its own. But the shuttering of Pungo Hospital in the largely black town of Belhaven is just another example of a US rural hospital closing up shop, Al Jazeera reports. Last year, 14 rural hospitals closed across the country, cutting off emergency services and curbing economic growth to entire communities. In Pungo's case, the hospital was Belhaven's biggest employer, so local officials are contemplating boosting property taxes by 10% to compensate for the revenue shortfall.
Why the closures? Experts are debating whether it's changing demographics, fewer federal reimbursement dollars, fewer insured patients, or health care's shift to a pay-for-performance model. But Pungo's closing was caused partly by North Carolina's decision not to expand Medicaid under ObamaCare, says the hospital's non-profit owner. Other states that rejected the expansion—like Tennessee, Georgia, and Alabama—have seen at least 11 hospitals close or cut back over the past two years, but Republican governors say the expansion would prove too costly over time. Meanwhile, a survey shows that the uninsured rate among poor people has fallen 11% in states expanding Medicaid, but only 2% in states that aren't, Huffington Post reports.