Since the start of the COVID-19 pandemic, I have hosted a series of conference calls with leaders of more than 120 hospitals across the state. They have told me about the heroic commitment and sacrifices of their front-line health care workers, the challenges faced in acquiring adequate testing supplies and personal protective equipment (PPE), and the difficulty treating patients with coronavirus while managing other patients who need to come in to give birth to a child, receive cancer care, or be treated after a stroke.
Across our state, these hospitals and their health professionals — from the physicians and nurses, to the custodial and intake staff — are doing incredible work and deserve our gratitude.
In Washington, I have worked to protect our health care system by helping to secure $175 billion in total funding to meet the emergency needs of our hospitals and health providers. The Coronavirus Aid, Relief, and Economic Security (CARES) Act and Paycheck Protection Program and Health Care Enhancement Act also expanded Medicare payments to help hospitals meet their payroll needs, invested $16 billion in the Strategic National Stockpile to restore our supply of PPE, and provided $25 billion to expand our testing capacity.
These important funds have helped to patch the enormous cash flow shortfalls for many hospitals.
But my calls with hospital leaders from across the state have highlighted a major challenge we continue to face: The financial vulnerability of our rural hospitals, especially in downstate Illinois.
Rural hospitals are the heart and soul of their communities. They are essential points for accessing health care when patients may otherwise face hours of travel for treatment. But they are also drivers of the local economy and often the largest employer. In Illinois, rural hospitals generate nearly $5 billion in direct spending on payroll, goods, and services.
But the pandemic is pushing them to the brink.
Even before this public health crisis, rural hospitals were facing financial uncertainty. Entering 2020, half of all rural hospitals nationwide were operating on negative margins and one in four was at risk of closure. Nationwide, one hundred twenty hospitals have been shuttered in the past decade.
In Illinois, hospitals have lost $1.4 billion each month during the pandemic according to the Illinois Health and Hospital Association. All have been forced to acquire additional personal protective equipment and postpone outpatient services. More than 80% of revenue for rural hospitals in Illinois comes from these elective procedures. And with COVID-19 transmission shifting to rural areas, our hospitals — especially those located near nursing homes or meat processing facilities — are seeing increased cases and inpatient capacity pressure.
To address this threat and provide stability for some of our most vulnerable rural hospitals, I have introduced the Rural Hospital Closure Relief Act with Senator James Lankford (R-OK). Congressman Kinzinger is leading this bipartisan effort in the House of Representatives. Our bill would update Medicare’s “Critical Access Hospital” designation to allow certain rural hospitals — facing financial losses in areas with shortages of providers and serving low-income communities — to quality for higher Medicare payments.
We estimate that rural hospitals across Illinois would qualify for our legislation’s financial lifeline, but Congress must act. For months, Senate Majority Leader Mitch McConnell, R-Kentucky, has stated he does not feel a sense of urgency to address the health and economic toll of this pandemic. Yet, the Kentucky Hospital Association projects more than 18 rural hospitals in his home state are at high risk of closing.
The cost of inaction is being felt across America. As the Senate debates the next COVID-19 relief bill, I will be joining with Sen. Lankford to push for the Senate to take up and pass our bipartisan bill that provides the financial relief rural hospitals across Illinois desperately need.
Dick Durbin is a Democratic United States senator representing Illinois.
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