Signs supporting Pungo Hospital dot the roadsides near Belhaven, a small coastal town. Belhaven's single stop light is visible in the distance in this 2014 photo.
Signs supporting Pungo Hospital dotted the roadsides near Belhaven in 2014, a small coastal town. Pungo's closure was the first high-profile hospital closure in North Carolina. Credit: Hyun Namkoong

By Rose Hoban

For the second year running, Belhaven Mayor Adam O’Neal has walked to Washington, D.C. Last year, O’Neal made the journey to raise the red flag over the closure of the hospital in his small eastern North Carolina town.

This year, he walked to raise awareness of rural hospitals facing closure across the country. He arrived at the Capitol on Monday morning.

Belhaven mayor Adam O’Neal (far right, with walking stick) poses with fellow walkers in front of the Iwo Jima memorial in Quantico, VA on Saturday.

“The purpose of this walk is that we want awareness that 283 hospitals are facing closure,” O’Neal said by telephone over the weekend as he neared D.C.

“A million dollars per hospital would make all the difference,” he said. “This is not a problem our country can’t fix; it’s a problem that no one is paying attention to.”

According to the National Rural Health Association, 53 rural hospitals across the U.S. have closed their doors since 2011; most of those are in the South.

Experts note several trends at play in Southern hospitals; in particular: Most states in the South declined to expand Medicaid as allowed for under the Affordable Care Act, and small, struggling hospitals lost the revenue they would have gotten from newly covered patients – revenue they were depending on.

“A lot of the closures are in Georgia and Texas, and Georgia’s hospitals have been struggling for years. They tend to have hospitals with smaller volumes,” said UNC-Chapel Hill health economist Mark Holmes in a recent interview with N.C. Health News. “I don’t think it’s clear whether the decision not to expand Medicaid pushed them into closure or whether it was a long-term trend and they just eventually fell over.”

O’Neal also pointed to federal sequestration, which cut payments to hospitals, as well as federal regulations.

And rural hospitals used to receive extra federal funding to care for people without insurance, funding that was phased out under the Affordable Care Act. The assumption in the law was that those patients would have had Medicaid.

Any fixes in sight?

O’Neal said he’s been joined on his walk by activists from Washington, Ohio, West Virginia, Tennessee, Texas, Pennsylvania and Illinois, along with others from North Carolina, which he found heartening.

“We are also hearing that some on Capitol Hill are introducing legislation in the coming weeks to address rural hospitals,” he said. “When a rural hospital closes, Republicans die, liberals die. This should be one issue for Democrats and Republicans to work together to fix.”

“We’re calling on Congress to pass comprehensive legislation to save rural hospitals and patients and to provide a pathway to the future for rural health,” said Alan Morgan, the National Rural Health Association’s CEO, in a press release.

Signs supporting Pungo Hospital dot the roadsides near Belhaven, a small coastal town. Belhaven’s single stop light is visible in the distance in this 2014 photo. Credit: Hyun Namkoong

O’Neal, a Republican, gained notoriety last year when he spoke out on Medicaid expansion in North Carolina, aligning himself with Democrats who have called on state lawmakers to expand the program. But for this walk, he said, he had the bigger picture in sight.

“The walk is not about Belhaven, it’s about hospitals closing in a lot of places,” O’Neal said. “Our country has somehow allowed this tragedy to come to our doorstep.

“It’s not finger-pointing. It’s just a nonviolent effort to get the government to pay attention.”

O’Neal ducked the question when asked if he’d put pressure on state lawmakers, where much of the legislation and regulation on hospitals in a state takes place.

“There are other people in North Carolina who can take up causes and do marches,” he said. “As far as I’m concerned, what people need to know is that 283 hospitals are at risk of closing.”




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