By Jane Winik Sartwell
East Carolina University Health is officially pursuing the idea of reopening Martin General Hospital, the shuttered hospital in Eastern North Carolina. But first, it needs $220 million — and for cuts to Medicaid to stop coming.
That’s starting to seem increasingly unlikely.
The uncertainty around the plan for Martin General shows just how vulnerable rural health care access is to the headwinds of policy decisions coming out of Washington and Raleigh.
ECU Health filed a letter of intent in July to reopen the hospital as a Rural Emergency Hospital, a new type of hospital for the state: one that sees only outpatient, emergent cases. The designation, created in 2021 by the Centers for Medicare and Medicaid, is a new tool to save struggling hospitals or revive closed ones.
But the cuts to Medicaid in Donald Trump’s Big Beautiful Bill, now law, are a serious curveball. More than 40% of Martin County residents are enrolled in Medicaid. The program would be a critical funding source for the hospital.
Meanwhile, at the state level, North Carolina’s recently passed minibudget falls $319 million short of fully funding Medicaid. It’s likely that the state will have to reduce what it pays hospitals for services provided to Medicaid beneficiaries.
Hospital and county officials say that as long as the legislature provides the $220 million they need, and a permanent solution to the Medicaid problem is determined, the plan is a go. Those are some big ifs.
“ECU Health and Martin County are committed to partnering together to build a sustainable model for health care in the community,” ECU Health spokesperson Brian Wudkwych told Carolina Public Press.
“While the nonbinding letter of intent represents an important milestone, there are many complex rural health care challenges that must be solved to make the proposed rural health care model a reality in Martin County. These challenges include navigating new federal health care legislation as well as securing vital public funding needed to build a long-term, sustainable regional system of care.”
In a break from the official line, ECU Health’s chief operating officer Brian Floyd told the New York Times that “the chances of reopening the hospital are low” due to the loss of Medicaid expansion. But Wudkwych and Dawn Carter, a health care consultant with the county, maintain that both parties fully intend to move forward with the plan.
The signals are mixed, to say the least. For Martin County, however, the confusion hasn’t crushed its dream of restoring the hospital.
“Martin County has, for the last two years, faced obstacles one after another, and worked tirelessly to get around and through all these different issues,” Martin County attorney Ben Eisner told CPP.
“Now we’ve got these Medicaid issues and federal headwinds. This little county is one of the smallest, most rural, poorest in the state. It has risen to the occasion anytime something’s been thrown its way. This is the little engine that could.”
ECU Health’s proposal would create a scaled-down version of the hospital. Rural Emergency Hospitals, or REHs, are not designed to provide inpatient services that would require overnight stays — think hip replacements, C-sections or appendectomies. For that kind of care, Martin County residents would still need to travel 30 minutes to the nearest full-service hospital, ECU Health Beaufort in “Little” Washington. Part of the $220 million ECU is asking for would go towards expanding capacity there.
CMS doles out $3 million to each REH each year in order to keep their doors open. They also receive higher reimbursement rates for each patient visit.
Due to the age and condition of the building, the new REH will be relegated to a corner of the old hospital. For residents of Martin County, the reopening of the hospital in any capacity would be a major boon.
“The closure has been a huge hit to the county in terms of lack of emergency care and transport times and strain on our EMS,” Eisner said.
“There’s the medical part of it, then there’s the economic part of it. ECU Health is a major economic engine in the eastern part of the state. This would have downstream effects of hiring new providers and staff. It could be really big for the region.”
If all goes well, Martin General would become North Carolina’s first Rural Emergency Hospital, clearing a path forward for other struggling hospitals across the state.
The post Medicaid cuts create hurdle for rebirth of Martin Co. hospital appeared first on North Carolina Health News.
