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Rural Doctors Could Be Casualty of ACA Repeal

Repealing the Affordable Care Act could hurt residency grant programs for doctors who serve rural areas. (Robert Daly/Getty)
Repealing the Affordable Care Act could hurt residency grant programs for doctors who serve rural areas. (Robert Daly/Getty)
April 28, 2017

BILLINGS, Mont. – As the GOP considers reviving plans to repeal and replace the Affordable Care Act with a revised American Health Care Act, the move could have serious consequences for rural Montana counties.

Tucked into the current system is the Teaching Health Center Grant, which helps fund residency programs for new doctors. One grant beneficiary is RiverStone Health, a teaching health center in Billings and the main source of doctors for rural Montana.

The center doesn't rely completely on grant funding, but Michael Geurin, who directs RiverStone's family-medicine residency, says without it, Montana will have fewer medical professionals.

"We would match for a smaller number of residents in the class, which would mean that three years later, we would be graduating fewer residents to go and become primary-care physicians in rural Montana," he explains.

Geurin says the grant currently helps them train three of their 24 residents each year. According to the Montana Department of Public Health and Human Services, 50 of the state's 56 counties have a primary-care doctor shortage.

RiverStone's training program was founded two decades ago for the purpose of keeping doctors in the state. At that time, Montana didn't have a residency program - Geurin says that's important because about 60 percent of doctors end up practicing in the region where they train.

Now, about 70 percent of RiverStone residents stay in Montana. But uncertainty about the grant has already affected planning. Geurin says RiverStone could be faced with taking in fewer residents.

"In public health, we don't have a lot of money just sitting around to help cover things if we run short," he adds. "So, most of what we do goes back into doing patient care for the under-served population that we care for."

Geurin says letters have been passed around in Congress to keep funding going for the Teaching Health Center Grant, but no legislation has been proposed.

Eric Tegethoff, Public News Service - MT