The Rural Health Opportunities Program, otherwise known as RHOP, is one of many scholarships available at Wayne State College.
RHOP is a scholarship only offered to students who are from rural communities within Nebraska, in the hopes that these students are more inclined to return to their small-town roots. Acceptance into this program guarantees students who are looking to have careers in various medical fields acceptance into the University of Nebraska Medical Center, UNMC. The fields included in RHOP are dental hygiene, dentistry, medical lab science, medicine, nursing, occupational therapy, pharmacy, physical therapy, physician assistant, public health and radiography.
When students apply for the scholarship, they must select one field to specialize in. If their applications are accepted, prospective recipients must go through interviews before being officially elected to receive an RHOP scholarship.
“I think it’s a good opportunity, and I highly recommend it to anyone who asks me about it,” Cady Uttecht, an RHOP recipient for dental hygiene, said.
However, there may be complexity to the scholarship due to one outlier. The possibility of changes to Medicaid and the potential for rural hospital closures as a result..
The One Big Beautiful Bill Act that was passed on July 4 will lead to a decline of health care providence for an estimated 15 million Americans, as well as $1 trillion cut from health care over the next 10 years according to the Congressional Budget Office. With drastic cuts to health care, there are concerns that rural health will be impacted more than urban health.
In anticipation of changes, multiple rural Nebraska hospitals are planning to close or limit their services in the coming months. This includes Curtis Medical Center in Curtis, NE. Other facilities in Nebraska have evacuated prior to the passing of this legislation due to financial struggles like the Regional West Physicians Clinics in Sidney and Chappell, which closed in 2023.
These changes will likely have the largest impact on emergency departments. The Emergency Medical Treatment and Labor Act, EMTALA, ensures that hospitals cannot turn uninsured individuals away from receiving necessary or stabilizing care.
“With smaller hospitals, it’s usually stabilize and transfer because in those small hospitals Medicaid and Medicare reimburses terribly. It’s the understanding that your hospital is going to lose money on those patients even though you can’t deny those patients,” said Blaike Bryan, an RHOP recipient.
The anticipated increase in uninsured individuals creates a cycle of health care avoidance. This means that rather than seeking preventative care, people wait until it is absolutely necessary to seek care, which leads to more people visiting emergency rooms. Even if patients want to receive preemptive care, many run into scheduling issues, as common work hours typically coincide with the hours a health clinic is open.
However, if patients are ill enough to require more intense care, the bills for the services provided will be exponentially costly. In the same vein, if the people visiting the ER are uninsured the hospital will absorb those costs.
With changes to Medicaid, insurance, and the potential for loss of care there is the potential for changes within programs like RHOP.
Despite these changes, Todd Young, coordinator of RHOP services at Wayne State College, is transparent that the program will have some challenges facing the future. However, as of now, no immediate action will be taken.
“I have no answer. That is not something that is immediately part of what my duties as the RHOP coordinator. It has yet to come up during one of my coordinator meetings. So far, UNMC folk have not presented us with any issues that we would collectively talk about. Honestly it has not come to the forefront.”
Even small actions could have major impacts
“I have already seen there are a few hospitals in Nebraska that are at risk of most likely going under. Hopefully Nebraska legislation is going to try to help,” Bryan said.
Bryan also had a personal story about seeking emergency care.
Bryan’s father had shown symptoms of a heart attack and had to be convinced to go to the emergency room. Once he arrived at the hospital, he coded.
Bryan said she thought that if her father lived farther from the local hospital, he would have likely died on the spot. She agrees that because of potential local hospital closures, these occurrences could become more common for Nebraska locals.
Overall, changes to Medicaid brought about by the passage of the Big Beautiful Bill Act could have numerous effects on the state of Nebraska. Including a loss of medical care for citizens, closures of rural health facilities, and changes to scholarships for those seeking careers in medicine.
