Your Golden Hour for a Golden Dome?

House to vote on immoral budget that sells out counties Trump won

We learned the importance of the “Golden Hour” in healthcare when Portia Gibbs died waiting for a helicopter to deliver her to a critical care center after her local hospital closed in Belhaven, North Carolina. Whenever someone suffers a cardiac event, the treatment they receive within an hour often determines whether they live or die. This is their “Golden Hour.” Because Portia lost her Golden Hour to politicians who refused to expand Medicaid in North Carolina for a decade, we lost her as a neighbor.

Right now in the US Congress, many representatives from rural America have to decide whether they are willing to trade their constituents’ Golden Hour for Trump’s Golden Dome. (This is a $100 billion increase to the defense budget that the White House is trying to shove through the reconciliation process, which doesn’t require 60 votes in the US Senate.)

The full text of the House’s funding bill for the federal government is stuck in the Budget Committee, where some extreme House members are insisting on even more cuts. Our partners at the Institute for Policy Studies have produced an important analysis of this bill’s devastating impacts, which are many. But the success of the bill likely depends on whether a handful of Republicans who represent rural districts are willing to sell out their own constituents.

Proposed cuts to Medicaid and subsidies for low-income Americans would mean 13.7 million of our most vulnerable neighbors would lose their healthcare. We have insisted from the beginning of this budget process that this a moral issue, more fundamental than any partisan commitment. But as Rep. Alexandria Ocasio-Cortez pointed out in the Energy and Commerce Committee mark up for this bill, it’s not only poor and low-income people who will lose access to healthcare. Everyone in many rural communities could lose their local hospital.

This is what we learned in Belhaven, North Carolina.

"Critical access" hospitals in America’s rural communities were established by the Hill-Burton Act of 1946, during the Truman administration, to provide life-saving healthcare to America's heartland, where people often find themselves too far removed from a regional hospital to receive timely treatment in an emergency. Because they do not see the volume of patients that have become the norm at major regional hospitals, these critical access hospitals often require federal subsidies to keep the doors open. This is nothing new; their existence has been a justified expense for millions of Americans since the mid-twentieth century.

When Congress passed the Affordable Care Act (ACA) in 2010, they planned for the essential federal funding that’s needed to keep critical access hospitals open to follow patients to their local facilities through the expansion of Medicaid. It was, as many conservatives had lobbied for it to be, a market-driven plan. But when Tea Party reactionaries branded the new law “Obamacare,” the term itself a dog whistle, they pushed the entire Republican Party to resist implementation of the ACA at every stage. Many state legislatures controlled by Republicans, like ours in North Carolina, refused to accept the ACA funding to expand Medicaid.

This meant that half a million uninsured North Carolinians who were technically eligible for Medicaid still couldn’t access health insurance. The vast majority of those uninsured people—350,000 of them—were white. But whatever the color of their skin, many of them lived in communities where their critical access hospitals were closing because they didn’t have the money the ACA had directed to fund them through Medicaid expansion.

“People are going to die,” the Republican Mayor of Belhaven at the time told us. We worked with him to file a Title VI complaint with the US Justice Department, asserting that the plan was discriminatory because it would deny Black people in Eastern North Carolina access to critical care. But we knew what Mayor O’Neal understood: closing the hospital would also impact the white Republicans who had elected him. Basic access to healthcare, we said, shouldn’t be a Republican or Democrat issue. It was a moral issue. “Now, Rev. Barber and I don’t agree on everything,” Mayor O’Neal told the reporters. “Heck, we don’t agree on most things. But we agree on this. We can’t let people die.”

Nonetheless, after a short delay, the courts couldn’t save the hospital from politicians who would not act to save it. When it shuttered its doors the following summer, emergency medical service workers in Hyde County made a plan for what to do if patients they would have taken directly to Pungo Hospital needed emergency care. Ambulances were to take them straight to the empty parking lot of a high school, and a helicopter would be sent to airlift the patient from there to a hospital in Norfolk, Virginia. That was the plan.

Days later, Portia Gibbs, a 48-year-old brunette and mother of three, was at home in Hyde County, cleaning up the yard with her husband, Barry, an Army veteran who worked in maintenance at the local school. From his riding lawnmower, Barry noticed that Portia had gone to sit down on the porch. He killed the engine and went to ask if she was okay. Her blood sugar had dropped, so he went inside and got her something to eat. But when he came back, Portia said her chest was hurting. Barry called their son to help him get Portia in the car, and Barry started driving toward the EMS station. He called ahead to let them know they were coming, and when they got there, four EMS workers put Portia in the back of an ambulance and got her stabilized. Then they told Barry they’d have to call for the helicopter.

Barry followed the ambulance to the high school parking lot and sat there for more than 45 minutes. One of the EMS workers came out to tell him they’d had to resuscitate Portia several times. They’d called the local doctor, who’d run Belhaven’s hospital for decades, to get his advice. He told them it didn’t sound good. By the time the helicopter finally arrived, there was nothing they could do to save her.

Portia Gibbs, just forty-eight, became the first recipient of the death-sentence that Belhaven’s Republican mayor had seen coming. Her unnecessary death was nothing less than a crime. If it had happened because of the unintentional neglect of law makers who were distracted by other responsibilities, they would still be culpable. But this was far worse than that. Her life hadn’t somehow slipped through the cracks. We had petitioned legislators at Moral Monday events to expand Medicaid. Hundreds of people had gone to jail when they told us to be quiet. A Republican had come to the statehouse and told members of his own party that their decision to refuse Medicaid expansion was going to kill people. Gibb’s death was, by any honest account, intentional. This was policy murder.

Soon in the US House, Republican representatives of rural districts across the US will have to make a choice: will they trade their constituents’ Golden Hour for the “Golden Dome” of military contracts that Trump wants to give his billionaire backers?

As we’ve said since the guiding resolution was introduced in Congress, the moral stakes of this moment are high. But this immoral budget’s success in the House comes down to whether a handful of Representatives decide to stand up for the Golden Hour of the people they swore an oath to represent. We continue to pray they find the courage to do what is right.

In this critical moment, we want to share two things you can do to join those crying out for life:

1) Sign on to our letter to Congressional leadership asking them to pray with us and a delegation of people who will be harmed by this budget before they cast their vote.

2) Join the Poor People’s Campaign field team to learn how you can petition your members of Congress:

Tuesday May 20th 8pm ET/7pm CT/5pm PT

REGISTER HERE

The Poor People’s Campaign will also host an open zoom line EVERY DAY this week, Tuesday-Friday at 2pm ET/11am PT for as many people as possible to come on and make calls! Join us every day by clicking HERE!