Tennessee hospitals have warned that some will close if the state doesn’t expand its Medicaid program as envisioned under the Affordable Care Act. Credit: Marissa Anderson via Flickr

This week brings a sobering reality to those who thought Tennessee hospitals were crying wolf about how bad things could get if the state opted out of expanding Medicaid. The announced closure of Haywood Park hospital in West Tennessee may be just the first, according to the Tennessee Hospital Association.

“We’ve seen this coming since the state decided not to do expansion,” says THA president Craig Becker. “We anticipate that there will be other hospitals that will be closing as well.”

THA hasn’t named names publicly. But it has said rural facilities are in a particular pinch. And the hospitals struggling the most sit in West Tennessee, which has been more economically stressed than the rest of the state.

Haywood Park was already in trouble, with  a decline in patients from 1,300 in 2009 to fewer than 250 last year. The emergency room has been seeing just 15 patients a day on average.

“Rural hospitals such as Haywood Park are particularly impacted by new cuts in federal program reimbursement as part of the Affordable Care Act,” the hospital says in a written statement explaining its closure. “These cuts were based on more people having insurance, whether through Medicaid expansion or the insurance exchanges.”

The Brownsville facility is owned by Franklin-based Community Health Systems. Somewhat ironically, hospital chains based in the Nashville area such as HCA and Lifepoint have been turning healthy profits for investors in the most recent quarter. THA’s Becker says that’s because they’ve gotten such a boost in the states where Medicaid has been expanded.