Rural health fund gaps highlighted in North Carolina hospital closure case
A new NPR report examines the limitations of a $50 billion rural health fund created under President Trump’s One Big Beautiful Bill Act, using Martin County, North Carolina, as a case study. Martin General Hospital closed abruptly in 2023, and a year later, 50-year-old Stanley Sears died of a heart attack. His sister, Debra Pierce, wonders if he could have been saved if the hospital were still open. County Manager Drew Batts stated the fund will not help reopen the closed hospital because North Carolina is distributing the money among existing health organizations, and federal limits restrict construction spending. Political figures in a competitive U.S. House race are debating the fund’s impact, with Republican candidate Laurie Buckhout criticizing incumbent Democrat Don Davis for voting against the bill. ECU Health, the region’s largest health system, signed a letter of intent to reopen Martin General as a rural emergency hospital, contingent on state funding and county refurbishment costs. The fund is paid in $10 billion annual increments over five years, with North Carolina receiving $213 million in the first year.
What’s reported
Martin General Hospital closed abruptly in 2023, surprising employees, patients, and local leaders.
Quorum Health, the operator, told county commissioners of ongoing financial challenges, according to spokesperson Lisa Anderson.
County taxpayers have spent an estimated $2.9 million maintaining the shuttered hospital.
The county is considering spending at least $1.5 million to create two paramedic units with advanced lifesaving equipment.
Sears died in 2024; emergency crews worked on him for a half hour but could not revive him for the drive to the closest hospital.
Martin County has no paramedics on its ambulances and can be 20 miles or more from the nearest ER.
ECU Health’s Greenville hospital, a Level 1 trauma center, has a median ER wait and treatment time of nearly 4.5 hours, longer than 96% of reporting hospitals.
The rural health fund was added in 2025 to win votes for the One Big Beautiful Bill Act, which will reduce federal Medicaid spending by more than $900 billion over a decade.
Don Davis introduced legislation to increase Medicaid reimbursements for rural hospitals, but it has not moved forward.
Laurie Buckhout’s campaign stated Davis voted against the bill and lost the hospital on his watch.
Conflicting accounts
Quorum Health spokesperson Lisa Anderson said the company had told county commissioners of the hospital’s ongoing financial challenges, while local leaders say the company did not notify them it intended to shut down operations and file for bankruptcy.
Open questions
Whether the state will provide the $210 million requested by ECU Health to reopen Martin General, and whether the county will approve spending on paramedic units.
Key figures
Debra Pierce: sister of Stanley Sears, resident of Martin County
Stanley Sears: deceased brother of Debra Pierce
Drew Batts: Martin County Manager
Brian Floyd: Chief Operating Officer of ECU Health
Don Davis: U.S. Representative (Democrat) for the district
Laurie Buckhout: Republican candidate for the same House seat
Stephen Gallagher: Buckhout campaign spokesperson
Thom Tillis: U.S. Senator (Republican) who voted against the bill
Matt Mercer: spokesperson for the North Carolina Republican Party
Michael Waldrum: CEO of ECU Health
Brian Wudkwych: ECU Health spokesperson
Lisa Anderson: Quorum Health spokesperson
Sources: NPR
