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Op-Ed: Ben Carson: Why policymakers need to protect Medicaid state supplemental payments
The Washington Reporter
Throughout my career — both as a neurosurgeon and as Secretary of Housing and Urban Development — I have seen firsthand the impact that strong, principled policies can have on struggling communities. From revitalizing neighborhoods through Opportunity Zones to implementing economic policies that lifted millions out of poverty, we proved that when government focuses on empowering people rather than controlling them, remarkable things happen.
Yet today, a looming crisis threatens some of the most vulnerable Americans — one that has been largely overlooked by the national conversation. It is a crisis not just of health care but of economic stability, national security, and fairness in governance.
For years, rural and underserved hospitals have been struggling to keep their doors open. Between 2010 and 2021, 136 rural hospitals
shut down. Today, 418 more are at
risk of closure, and last year alone, 50 percent of rural hospitals lost money. If this trend continues, entire regions of the country — many already suffering from limited access to medical care — will be left without essential health services.
Medicaid state supplemental payments have been a critical lifeline, allowing states to stabilize their hospitals without increasing taxes on their citizens. These payments ensure that care remains available in rural and low-income areas, where hospital closures could mean the difference between life and death.
During the previous administration, bureaucrats attempted to
gut state Medicaid funding through sweeping government overreach that would have disproportionately harmed rural and underserved communities. These proposals are still being quietly advanced through bureaucratic efforts to advance the former administration’s agenda — without congressional approval and without regard for the devastating impact the policy would have on hospitals, patients, and communities.
One of the most troubling aspects of this issue is the selective targeting of states based on politics rather than based on policy.
Reportsindicate that the Biden administration attempted to cut off funding specifically to states with Republican leadership — like Florida, Texas, and Missouri — while allowing similar programs to continue in blue states.
This is not how a government should function. Health care should never be used as a political weapon, and the lives of rural Americans should not be collateral damage in a partisan power struggle.
This type of governance breeds distrust and exacerbates divisions in our country. We should be working toward solutions that strengthen health care for all Americans, not selectively dismantling programs to score political points.
Beyond the immediate health care implications, the financial instability of our hospitals presents another urgent concern: national security. As some hospitals struggle to stay afloat, foreign investors — especially those from China — are aggressively seeking to purchase American health care institutions.
This should alarm every American. Our health care system holds vast amounts of sensitive patient data, and allowing foreign adversaries to gain control over U.S. hospitals poses a direct threat to both personal privacy and to national security. Yet, if our hospitals continue to be financially squeezed, the door will be left open for these concerning acquisitions.
Hospitals are more than just health care facilities. They are economic anchors in their communities, providing good-paying jobs, serving as major employers, and ensuring that local governments have a stable tax base. Every hospital closure not only limits access to care but also weakens the economic foundation of the communities they serve.
If we allow bureaucratic overreach to erode the financial stability of our hospitals, we will not only deepen the health care crisis, we will lose a vital part of our national infrastructure.
I do not suggest that Medicare and Medicaid should be beyond scrutiny from oversight bodies. Accountability is essential. However, we must also recognize the critical importance of maintaining steadfast support for the most vulnerable among us.
Health care spending in the United States has undeniably reached unsustainable levels and must be addressed through meaningful reform. However, as we strive for greater efficiency, we must ensure that compassion and fairness remain central to our health care system. Before making cuts to essential funding, we must thoroughly evaluate the real-world impact on those who depend on these services.
This is not a conservative or a liberal issue; it is an American issue. Every citizen deserves access to quality health care, and every community deserves the economic stability that hospitals provide. Policymakers must protect Medicaid state supplemental payments and ensure that no community is left behind due to political gamesmanship.
The future of health care in America depends on it.
Dr. Ben Carson is the Founder of the American Cornerstone Institute and the 17th U.S. Secretary of Housing and Urban Development.