Time for Texas to Save Rural Healthcare

Rural Texas cannot survive literally or economically without vast improvement to its healthcare system. The Texas Department of Agriculture (TDA) includes the State Office of Rural Health, a rural hospital program, and has responsibility for rural economic development. Rural healthcare has been dying on the vine with more than two dozen hospitals closing in the last several years resulting in Texas leading the nation in rural hospital closures since 2010 and 55% of the remaining rural hospitals in danger of closing.

Rural Texas is older, less healthy with higher heart disease, cancer, and respiratory disease rates, more prone to injuries, but less likely to be insured than urban Texas. Those with means will leave rural Texas as they age because of the lack of healthcare taking with them their discretionary spending in the community. To turn rural healthcare around, Texas needs leadership, effective analysis of the needs of rural Texas and the resources available to help, and the energy to find additional resources to fill the gaps.

First, Texas must expand Medicaid. This would help rural Texas in two ways. The uninsured will get access to health care keeping those individuals healthy, working, and productive. Expanding Medicaid will also make rural hospitals more economically viable. When an uninsured person hits the ER, the hospital eats the tab. The more insured people in a community, the more likely it is that community’s hospital can pay its own bills and stay open. Medicaid is funded by our tax dollars. Refusing to expand Medicaid just to spite Democrats only ships our money off to other states while shortchanging Texans.

Second, create more competition and options in the health insurance marketplace. Rural Texans have fewer health insurance options compared to their urban counterparts. Many rural counties have only one or at best two private health insurance carriers offering coverage. Fewer health plans in rural areas mute competition and gives health plans a monopoly to set unaffordable, take-it-or-leave-it health insurance premiums. Health insurers can also pick-and-choose to operate only in urban counties, essentially redlining rural patients. Redlining patients must stop. To improve competition and stimulate growth in rural counties, the Texas Department of Insurance should require health insurers to operate in the surrounding counties within the entire rating/coverage area.

Third, promote a more robust healthcare workforce in rural Texas. There are multiple ways to do this. Start by promoting health care education to rural kids who are more likely to work in rural areas after completing their education. Prioritize admissions to health care education programs for underrepresented rural and rural-interested students as they are most likely to practice in rural Texas once licensed. Support training programs for doctors set in rural Texas. If a doctor trains in the country, she’s more likely to stay to work in the country. TDA can tap into federal funds through the USDA to help local communities decide what methods work best for that individual community.