The Iowa Senate has approved a measure allowing some medical facilities to be licensed as "emergency hospitals." This would be especially important in rural areas facing a critical-care shortage.

Senate File 75 would allow some Iowa hospitals to be given a Rural Emergency Hospital designation, which could keep many of them open. Although it might seem unusual for a hospital to reduce services to increase patient care, this designation would require some to discontinue inpatient care in exchange for offering outpatient services and a 24/7 emergency room.

Sen. Jeff Reichmann, R-Montrose, said access to round-the-clock care services is increasingly vital.

"Rural Emergency Hospitals will help rural communities that need health-care services, stabilize hospitals that may be struggling in rural areas, and help ensure that essential needs for Iowas, and specifically for us in Lee County, are met," he said.

Under the Rural Emergency Hospital designation, the facilities would get higher Medicare reimbursement rates and additional monthly federal payments in exchange for forgoing inpatient care. So far, the bill has faced token opposition from one senator who pointed out that it won't help urban hospitals.

The Iowa Hospital Association said 140 hospitals have closed nationwide in the last decade, including one in Iowa.

If the Senate bill becomes law, said Sen. Martin Graber, R-Fort Madison, it would be a big part of making sure that more rural hospitals don't face the same fate.

"There aren't very many times that you and I get the opportunity to vote on a bill that could mean life or death to people," he said. "This one does that, OK? When it's fully implemented, it'll make a difference."

Rural Emergency Hospital designation, and the Medicare reimbursements and payments that go with it, would also be available to rural surgical centers that provide outpatient services. The bill heads next to the Iowa House.

A Georgia health advocacy group is concerned about people's health outcomes as the COVID-19 public health emergency is set to expire on May 11. The Medicaid "continuous coverage" requirement starts to unwind on April 1, and an estimated 545,000 Georgians could lose their health insurance in the process.

Paige Havens, health equity program lead for the Gwinnett Coalition, said its goal is to raise awareness about the changes that will affect people's insurance status - and access to COVID-related resources. She said those who want the latest COVID vaccine should get it while it may still be free, based upon their Medicare, Medicaid or PeachCare coverage.

"That is going to become an individualized basis," she said. "We're going back to that normal health-care model where, based upon where you are and what coverage you have, will determine if you have any out-of-pocket expense."

Havens emphasized that free COVID-related services offered by private companies will begin to roll back once the health emergency ends. She noted that fewer options and choices will be available, and mobile units could also shut down because many were funded by federal dollars.

Havens emphasized that Gwinnett is a diverse county, and the Coalition works to remove cultural and language barriers that can limit residents' access to health care. She noted that there's still a 2% gap in vaccination rates between Black and white populations, and a 7% gap between Hispanic and non-Hispanic rates. She said they're focusing on those groups.

"So again," she said, "that's why we're looking at saying, 'How can we rally around those clinics who serve our uninsured? How can we educate people about where those resources are?' So, our goal really will be to continue strongly messaging around, 'Where are the resources?' "

She explained that people enrolled in Medicaid, Medicare and PeachCare will be asked to reapply, and the process of redetermining eligibility will take 12 to 18 months. Providers will be reaching out to people who need to reapply, and Havens said if they do so, it's important to respond in a timely manner to avoid a gap in health coverage.