Adam O’Neal, the Republican mayor of a small North Carolina town named Belhaven, is currently on a nearly 300 mile journey to the nation’s capital to raise awareness for a cause that’s rather unpopular within his own party. This week, the mayor started walking to Washington, DC on foot, hoping to bring more attention to the human consequences of rejecting Obamacare’s optional Medicaid expansion.
Since North Carolina hasn’t yet agreed to expand Medicaid, the hospital serving O’Neal’s rural constituency was recently forced to close. Vidant Pungo Hospital, which used to care for a disproportionately large population of low-income and uninsured patients, can no longer afford to remain operating in Belhaven. If the state had expanded Medicaid, however, things may have turned out differently. Vidant Pungo would have received an influx of newly insured patients; like the hospitals located in states that accepted Obamacare’s expansion, Vidant’s profit margins probably would have improved.
Now, Belhaven’s residents have to travel nearly an hour to get to the closest hospital, something that has created what O’Neal calls “a medical desert.” So he’s marching 273 miles to Washington to find a solution.
“Our state’s refusal to accept expansion is taking two billion dollars a year out of our state’s healthcare system,” the mayor wrote in an op-ed to explain why he’s making the trek over the next two weeks. “Americans need to realize the rural healthcare struggles across our country. In the last year, more rural hospitals have closed than in the previous 15 years. Every hospital closure means deaths!!!”
In order to make that point, O’Neal is recounting the story of 48-year-old Portia Gibbs, who he says may not have died if she had been able to go to Vidant Pungo. Last week, Gibbs passed away after suffering a heart attack while emergency responders were waiting for a helicopter to transfer her to the closest hospital, which is now located 75 miles away. O’Neal points out it may have turned out differently if Vidant Pungo, which was 47 miles away, was still open.
Although some emergency responders say that a closer hospital wouldn’t have saved Gibbs, her family is still upset that she never had the option to receive emergency care in Belhaven. They joined O’Neal when he kicked off his two-week march on Monday, saying they want to prevent more potential deaths.
O’Neal and his supporters believe the decision to close Vidant Pungo Hospital violated the Civil Rights Act of 1964 because it disproportionately impacted African Americans in the state who rely on that safety net hospital. Earlier this year, the North Carolina chapter of the NAACP filed an official complaint with the Department of Justice on those grounds. The DOJ initially negotiated a settlement that required Vidant Health, the regional health care system that ran the Pungo Hospital, to work out a plan to transfer control of the hospital’s operation. But that plan ended up falling apart, and the civil rights complaint has since been re-filed. The president of North Carolina’s NAACP, Rev. William Barber — who has been an instrumental player in the state’s ongoing Moral Monday movement — will join O’Neal on the first leg of his walk.
North Carolina isn’t the only state where this dynamic is unfolding. Rural hospitals are also being forced to close in states like Virginia, Georgia, and Tennessee in the absence of Medicaid expansion. The Rural Policy Research Institute sees the fight over this particular Obamacare provision as one of the most important issues facing its constituency.
“Belhaven’s battle to hold onto emergency healthcare is shaping up to be a do-or-die challenge for rural America,” O’Neal explained at a recent county commissioner meeting, when he announced his intention to begin his march. “When it’s do-or-die, it’s no time to sit still. That’s why I’m walking.” The mayor is hoping to schedule a meeting with Attorney General Eric Holder and President Barack Obama once he eventually arrives in Washington.