Kimberly Adams

All right, we are going to take a quick break.

We'll be right back.

All right.

We are back with Arielle Zients of KFF Health News.

I want to get more into those Medicaid spending cuts that were passed last year.

I know that most of them aren't really supposed to kick in until after the midterms.

But at the same time, a lot of these health care systems across the country know that these are coming.

How are you seeing rural hospitals preparing for this?

And you also recently reported about a hospital in South Dakota that closed its labor and delivery unit.

You know, it strikes me, and I feel like I've read a bunch of stories about this, that you're often hearing about labor and delivery units closing in rural areas.

Why is that?

So what have you seen in your reporting in terms of projections of how these cuts are going to land in rural communities, particularly when it comes to rural hospitals?

And I guess these issues that you laid out more of people already skipping preventative care because they don't have Medicaid anymore or because Medicaid doesn't cover as much anymore.

And then the hospital shuts down in your area.

When you do need that emergency care, you have to go even further to get it, which I imagine also increases costs and risks.

At the same time these Medicaid cuts are coming down the pipeline, we are also seeing lots of people dropping health care coverage through the ACA exchanges, the Affordable Care Act exchanges, because of the subsidies that Congress failed to extend.

And there were negotiations to try to maybe do something to extend them that have been going on, but those negotiations appear to be dead.

How do you think the loss of those subsidies and the way that that's going to play out is going to affect rural communities in particular?

So with all of these changes coming down the pipeline that we know are going to disproportionately impact rural communities, as you've been reporting on this, have you come across any creative solutions that you think might actually make a difference in this process?

And in the workforce development slice of it, is there money in this rural health transformation program to actually train more health care professionals and get them into rural areas?