Iowa’s rural hospitals have struggled to meet the challenges of COVID-19. While they are resilient, they need our support more than ever.
Even before COVID-19, long-standing challenges with Medicare payments and access challenges left them in tough financial situations. But their support is especially needed today, due to a looming deadline to begin the repayment of loans granted under an expansion of the Medicare Accelerated and Advance Payment Programs (MAAPP).
As a rural Iowa cancer survivor, I am keenly aware of the necessity to maintain vibrant rural hospitals. The rural hospitals provide many of our yearly maintenance testing protocols. Losing even one rural hospital due to the crippling effects of COVID-19 would be one too many.
Back when COVID-19 first emerged in our state, the federal government stepped in to provide assistance to our health care system. The existing MAAPP program was activated and provided a lifeline to our providers. However, we are now reaching a tipping point that must be addressed by Congress.
According to the MAAPP loans — which gave hospitals advances on their Medicare payments — repayment must begin 120 days after receiving the loan. For most hospitals, that deadline is now. Hospitals only have 12 months to repay the loans before accruing interest at the egregious rate of 10 percent. Most importantly, until a hospital has finished paying off a loan, it will not receive Medicare payments for services they provide to beneficiaries, significantly impacting their bottom line. This means that a hospital would continue to provide Medicare services like they would normally, yet would not receive the proper payments from the federal government. Remember, we are still in the middle of a pandemic and rural hospitals are taking drastic measures just to keep their doors open.
U.S. Senate Republicans have taken an important step in addressing some of these terms in their COVID-19 relief package; however, more work needs to be done. More flexibility is needed as many hospitals in rural Iowa are still catching up to the unprecedented impacts of COVID-19.
I encourage Sens. Chuck Grassley and Joni Ernst, who have long supported our hospitals, to push for bigger, much-needed changes — including extending the start of loan repayments to a year and the total repayment period to at least 36 months. The interest rate should also be waived or limited This leadership would ensure Iowa’s rural hospitals have the resources they need to keep their doors open to serve patients and communities during this critical time.
Marlys Popma lives in Kellogg.