In swing state North Carolina, a shuttered hospital erodes trust in elected leaders

When a North Carolina city lost its only hospital, its residents lost a sense of security and care for their well being. Health care is featuring prominently in the presidential election as the nation faces a worker shortage and more rural hospitals close.

First Look

Weeds have punctured through the vacant parking lot of Martin General Hospital’s emergency room. A makeshift blue tarp covering the hospital’s sign is worn down from flapping in the wind. The hospital doors are locked, many in this county of 22,000 fear permanently.

More than 100 hospitals have downsized services or closed altogether over the past decade in rural communities like Williamston.

When Quorum Health shut down Martin County’s 43-bed hospital, citing “financial challenges related to declining population and utilization trends,” residents here didn’t just lose a sense of security. They lost trust, too, in the leaders they elected to make their town a better place to live.

People like Bobby Woolard say they don’t believe any politicians – from the local county commissioners to the presidential candidates who will pass through this swing state with big campaign promises in the coming months – care enough to help them fix the problem.

“If you’re critically ill, there’s no help for you here,” Mr. Woolard said on a sunny April afternoon while trimming his neighbor’s hedges. “Nobody seems to care. You got a building sitting there empty and nobody seems to care.”

The sentiment in this sharply polarized and segregated eastern North Carolina county could hint at trouble for President Joe Biden, who has made health care a key part of his reelection campaign against Republican rival Donald Trump.

His TV campaign ads hone in on Mr. Trump’s promises to diminish the Affordable Care Act. On social media, Mr. Biden regularly reminds followers of the law he signed that caps the cost of insulin. And in North Carolina, the campaign is narrowly focused on promoting Democrats’ successful efforts to expand Medicaid, which will extend nearly-free government health insurance to thousands of people and reduce the indigent population for hospitals.

Mr. Biden and Mr. Trump are fiercely competing for the state, which also features the most prominent governor’s race of the year. Martin County, where Williamston is located, voted for Mr. Trump in 2020.

“Health care is on the ballot this year, and voters will remember that when they reject Donald Trump in November,” said Dory MacMillan, the Biden campaign’s North Carolina communications director.

But Mr. Biden’s achievements might not be enough for crucial voters living in towns like this one in North Carolina, where people have a hard time getting emergency care.

Nationally, emergency room wait times have ballooned, with the average emergency room visit taking nearly three hours last year, according to the Centers for Medicare and Medicaid Services. Health care systems are also grappling with a health care worker shortage that worsened after burned-out employees emerged from the pandemic.

Those problems are particularly pronounced in rural communities, where more than 68 hospitals have closed in the last decade. The closures slowed down during the COVID-19 pandemic, when the federal government doled out billions of dollars in extra funds to hospitals. But with that money spent, hospital closures might tick up again, said George Pink, the deputy director of the University of North Carolina’s Sheps Center’s Rural Health Research Program.

More than a dozen Williamston residents interviewed for this story blamed the Martin County Board of Commissioners for failing to prevent the troubled hospital from closing.

The county, which still owns the hospital and land, is consulting with state officials and federal Health and Human Services agency representatives to determine whether the facility can reopen as a Rural Emergency Hospital, said interim County Manager Ben Eisner. Gov. Roy Cooper helped to usher in a new state law that allows North Carolina’s rural hospitals to make the transition.

The Rural Emergency Hospital program was developed by Congress, signed into law by Mr. Trump, and finetuned by the Biden administration. The designation allows rural hospitals to unlock millions of federal dollars and beef up Medicare payments if they stay open to provide 24/7 emergency care.

“The simple question we’re trying to answer is how do we go from closed to open in a way that makes sense for the citizens of Martin County,” Mr. Eisner said.

If successful, Martin County would be the first hospital in the country to reopen its doors after closing with the new federal designation.

“It’s a top priority for us, we live it every day as a community,” Ms. Paxton said of getting the hospital reopened. It’ll be top of mind for her when she votes in the presidential election this fall.

This story was reported by The Associated Press.