A proposed change in Medicare could mean major cuts in federal funding for about half of Iowa’s hospitals. Seventy Iowa hospitals that are currently classified as a “Critical Access Hospital” would lose that designation and the enhanced Medicare payments that come with it.

“Critical Access Hospitals” must have 25 or fewer in-patient beds and the facilities cannot be less than 35 miles from another hospital. That distance limitation is now waived, but the proposed change would enforce it and bring a significant reduction in Medicare reimburement rates for those 70 Iowa hospitals.

“It would be pretty devastating,” says Viva Boershel, director of nursing at the Floyd County Medical Center in Charles City. “Financially it would be pretty difficult, ours as well as other small hospitals, to be able to continue. We’d have to be looking at other financial resources.”

Iowa Senators Tom Harkin and Chuck Grassley were among 20 U.S. senators who signed a bipartisan letter criticizing these cuts and the Iowa Hospital Association is also lobbying against the change.

“I think there are a lot of people that are fighting for the rural hospitals and so I would certainly hope that that would be the case and that’s what we’re thinking now is we certainly have good people out there now fighting to maintain the ‘Critical Access Hospital’ designation for the rural hospitals,” Boershel says.

Senator Harkin, who is chairman of the senate committee that deals with health care issues, says without the higher Medicare payments, these 70 rural Iowa hospitals “would not be able to survive.”

The Critical Access Program provides extra money to more than 1300 small-town hospitals in the United States. Through an open records request to the federal government, The Des Moines Register got a list of the 70 hospitals that would face deep cuts. According to The Register, the hospitals are in the following towns: Albia, Algona, Anamosa, Atlantic, Audubon, Belmond, Bloomfield, Boone, Britt, Chariton, Charles City, Cherokee, Clarinda, Clarion, Corning, Cresco, Creston, Denison, De Witt, Dyersville, Elkader, Emmetsburg, Estherville, Fairfield, Grundy Center, Guttenberg, Hamburg, Hampton, Harlan, Hawarden, Humboldt, Ida Grove, Independence, Iowa Falls, Jefferson, Knoxville, Lake City, Le Mars, Leon, Manchester, Maquoketa, Marengo, Missouri Valley, Mount Ayr, Mount Pleasant, New Hampton, Manning, Nevada, Onawa, Orange City, Osage, Osceola, Oskaloosa, Pella, Perry, Primghar, Red Oak, Rock Rapids, Rock Valley, Sac City, Sheldon, Shenandoah, Sibley, Sioux Center, Storm Lake, Sumner, Washington, Waverly, Webster City and West Union.

(Reporting by Angela Barton, KCHA, Charles City)