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Brewton physician Dr. Dan Raulerson summed up the need for Medicaid expansion in the state Monday night during a forum held at D.W. McMillan Hospital.

“No hospitals, no ER to come to,” Raulerson said. “No hospitals. No surgery. No lab. No blood work. No ICU. No anesthesia. We need to do what it takes to keep the hospitals in this town and in this county.”

The possibility of losing hospitals, especially in rural communities, is just one reason those present at the forum are in favor of the statewide expansion.

Without Medicaid expansion, most rural hospitals will not be able to provide quality care to its residents. Without the expansion, funding for most hospitals will continue to dwindle.

Stacey Hines, administrator at D.W. McMillan Hospital, said the accounts receivable for self-pay patients continues to be an issue for her hospital and for Atmore Community Hospital in Atmore.

“Last month, our accounts receivable for self-pay patients was $5.7 million,” Hines said. “In Atmore, it was $3.9 million. We have 15 percent of our patients who are uninsured and Atmore has 14 percent uninsured patients.”

Hines said with expansion of Medicaid in the state, that number would drop by as much as half.

“That would provide significant financial relief for our hospitals,” Hines said. “That would help insure there is access to care for all of us.”

The forum focus was to encourage residents for the need of expansion of Medicaid eligibility for the state. The risk of losing hospitals is real with the current state of financial stress on the systems.

Brad Lowery, administrator at Atmore Community Hospital, said the expansion would allow county hospitals to continue offering needed medical services to all patients.

“We are lucky to have the services we provide in our county,” Lowery said. “But, without the expansion, we are at risk for the care not to be available. What ends up happening is people without any insurance don’t seek medical care and they don’t have a good outcome. Any business can only operate in the negative for so long, and then you see those facilities being removed when the numbers get worse.”

Pediatrician Dr. Marsha Raulerson said the expansion would provide care for more than just the children and very low income residents in the county and health outcomes get better for everyone when proper care is available.

“If parents have healthcare, their children do better,” Raulerson said. “I’ve seen kids turn 19 and lose their healthcare. They no longer get the medications and care they need and are forced to go on disability. That’s not what they want. I have special needs patients that are going to lose their healthcare on April 1.”

Raulerson also relayed details of how other states have seen what Medicaid expansion can do.

“In 2013, Arkansas expanded Medicaid in their state,” Raulerson said. “They lost one hospital that year. In that same year, Alabama lost 11 hospitals.”

Presdelane Harris, with Alabama Arise – host of the forum, said it is up to residents of the state to speak out concerning the Medicaid expansion in the state.

“It’s up to you to reach out to lawmakers about why this matters,” Harris said. “Adequate health coverage saves lives and those who make the decisions need to hear from us.”

Harris encouraged state residents to contact legislators any way possible to have this issue addressed and approved.

“Make a call, write a letter or email,” Harris said. “Even make face-to-face contact if possible. The more voices we have, the more we can advocate for change.”