ABC33/40: Alabama’s rural hospitals face closure crisis, urgent solutions needed
AlaHA Deputy Director and COO Danne Howard, along with Bibb Medical Center CEO and chair of AlaHA’s Rural Constituency Section, Joseph Marchant, spoke with ABC33/40 about the urgent challenges facing rural hospitals and the potential impact of the Alabama Rural Hospital Investment Tax Credit.
by Cynthia Gould
Wed, April 23rd 2025
MONTGOMERY, Ala. — Rural hospitals across Alabama are grappling with severe financial challenges, with many at risk of closing, which could place additional strain on urban healthcare facilities. Danne Howard, CEO and Deputy Director of the Alabama Hospital Association, highlighted the dire situation, stating, “Unless things change, it’s only going to get worse.”
According to Howard, 27 hospitals are in danger of closing, with 19 at immediate risk. She emphasized the broader impact, saying, “The rural issue is not just about rural Alabama, it’s about all of us. If the rural hospitals are not there stable enough, urban hospitals cannot absorb the volume.” Howard warned that the closure of these facilities could lead to a shortage of staff and space, jeopardizing access to healthcare for many.
Currently, only 15 hospitals in Alabama have full 24/7 labor and delivery units, and 71 percent of hospitals are operating with negative margins. The situation is even more critical for rural hospitals, with 83 percent facing financial difficulties. These hospitals are not only vital for healthcare but also serve as economic drivers, providing jobs and boosting local economies.
To address the crisis, the Rural Hospital Investment Program is moving through the legislature. Modeled after Georgia’s program, it offers tax credits for donations to rural hospitals, which can be used for essential upgrades and repairs. Joseph Marchant, CEO at Bibb Medical Center, echoed the concerns about hospital closures stating, “Those deserts are already occurring.”
Advocates are urging the public to voice their concerns to legislators, emphasizing the importance of healthcare and the economy.
Another critical component is expanding health insurance coverage. Currently, 200,000 Alabamians cannot afford insurance, and Medicaid expansion could provide relief. However, Alabama remains one of ten states opting not to participate in the federal Affordable Care Act.
Statement from Debbie Smith, Alabama Arise’s Cover Alabama campaign director:
Statement from Debbie Smith, Alabama Arise’s Cover Alabama campaign director:
When a rural hospital or clinic closes, it closes for everyone. As these facilities disappear, so do health care options for people in rural areas across Alabama, putting lives at risk and devastating local economies. Alabama can and should act now to protect rural health care access by closing the health coverage gap through Medicaid expansion.
Medicaid expansion would ensure health coverage for nearly 200,000 Alabamians who cannot afford it otherwise, many of whom work in essential but low-paying jobs like construction and food service. It would boost workforce participation, create thousands of jobs and help rural hospitals and clinics remain open to serve everyone in their communities. And most importantly, it would save and improve lives across our state.
Closing Alabama’s health coverage gap is an economic and moral imperative. It’s time for our policymakers to expand Medicaid and invest in a healthier future for the people of our state.