Unicoi hospital rebuild timeline unclear amid Medicaid cuts

ERWIN — The timeline of the Unicoi County Hospital rebuild is still up in the air — but Ballad Health remains committed to the project.After flooding from Helene forced dozens to evacuate from the hospital roof and destroyed the facility last year, the plan was pretty straightforward: Ballad would rebuild. The state of Tennessee and the Federal Emergency Management Agency approved $9.8 million for the project in February, and action was underway to secure a new hospital."We were in the process of acquiring land, working on designs and then to rebuild the facility as we had it before," said Eric Deaton, Ballad's chief operating officer.Then President Donald Trump signed the "One Big Beautiful Bill" into law on July 4. The law will make sweeping changes to Medicaid in the next decade, a provision that has prompted uproar from both sides of the aisle as experts and hospital systems warn that the cuts will disproportionately affect rural hospitals and health.Ballad Chairman and Chief Executive Office Alan Levine was just one hospital executive warning the public that the legislation would have consequences."The 'One Big Beautiful Bill' made us take a pause," Levine said in a recent interview with Six Rivers Media while discussing the county hospital. "If you spend $50 million to build a hospital, that by the time it opens you're going to face $125 million in cuts, then you're having to start to talk about if you have to possibly close hospitals, how wise was that decision?"Both Deaton and Levine said the rebuild is estimated to cost around $50 million. The original hospital, which opened Oct. 23, 2018, cost over $30 million."If you're obtaining money or funds from the federal government and from the state, you want to make sure that you're prudent in the way you invest that money into the community," Deaton said. "[Medicaid cuts] would have significant impact on the ability to have a facility that has a positive margin moving forward with it."Having a positive margin is important, Deaton added, because that money goes back into providing salaries and increases for staff. With cuts coming in 2028, Deaton said that the whole situation is concerning."[It] could actually wipe out our entire bottom line," he said. "When you look at making this type of investment to rebuild the facility, it's hard to do that with that type of deficit you're trying to make up."Is it possible that the rebuild won't happen?"I think it's a real possibility," Deaton said, "given what we're facing with Medicaid cuts in the next two to three years."Levine said that making sure emergency services are available to the community is a top priority in the interim. Ballad already has an advanced urgent care clinic in Erwin to continue critical services."There's a wide range of things you can look at outside of doing the hospital," Deaton said. "But we'll just have to see into the future how we can invest that money the best."As far as taking the next concrete step toward a new hospital, Deaton said he'd "love to do it tomorrow." He said that the health care system has narrowed down a possible site for the facility, but plans are still ongoing."What we're doing right now is evaluating the services that we can do there, given the current state," he said. "The other thing we're really engaged on is working with our legislators at the state and especially at the federal level."Overall, the health care system remains committed to Unicoi County, Deaton emphasized."We love the people there and we want to continue to support them," he said. "So we're going to do everything we can to continue to push for building this hospital."