Rural hospitals vulnerable in states without Medicaid expansion

Rural hospitals in states likely to opt out of the Medicaid expansion under the Affordable Care Act could be hit the hardest by a continuing stream of uninsured patients coming through their doors, Marketplace has reported. States such as Tennessee, which contain many rural regions with working poor residents who earn too much to qualify for Medicaid but can't afford to buy insurance on the exchanges, could find their hospitals impacted as a result.

Bell Royton, a registered nurse at Partners for Healing in Tullahoma, Tenn., noted that patients often can't even fill prescriptions that cost as little as $10. "It might as well have been $1,000," she told Marketplace. Moreover, hospitals in rural parts of Tennessee have been hit by the recent budget sequester that cut Medicare rates by 2 percent, and that as many as a third of them are in danger of closing. Article