Rural residents waiting on legislators to resuscitate Martin General Hospital
WILLIAMSTON, N.C. — Elected officials in the North Carolina General Assembly are unable to agree on funding priorities for the people who sent them to the legislature. A final working version of the state budget isn’t expected until late July or August, according to an official close to the money talks. It means to date, there is no guaranteed line item to fund the reopening of Martin General Hospital.
Martin County commissioners are considering a pitch from ECU Health to reopen Martin General as North Carolina’s first rural emergency hospital. It’s a hard-and-fast pitch — no money, no hospital, ECU Health CEO Michael Waldrum said.
“It’s very important that the state helps us with this,” Waldrum said. “We’re so fortunate to have legislators that understand these issues and that they are committed to having a rural emergency hospital in North Carolina.”
During a June 4, 2025, public hearing inside the Martin County Government Center, all eyes from an overflow crowd were on state Rep. Shelly Willingham. He heard Waldrum make a case for the $70 million needed to reopen Martin General, and the representative listened to Martin County residents plead for him to persuade his political peers to figure it out and produce the money to make a hospital happen here.
Martin General closed in 2023 when the Williamston Hospital Corporation filed for Chapter 7 bankruptcy. It has meant Pete and Delores Wilson going outside of Martin County to access health care — like earlier this year when the rescue squad delivered him to ECU Health Edgecombe Hospital. His blood sugar and blood pressure were low. The man is 80 years old and has to keep tabs on his heart condition and asthma, too.
“If we’re in critical care, we need help then,” Delores Wilson said. “We don’t need to wait 35, 40 minutes to get some help. We need help then.”
Rescuing rural communities
Martin County residents forgoing the lights and sirens of ambulances are looking at 25- to 45-minute drives to emergency rooms in neighboring counties, said Latonya Jenkins, human services deputy director for the Martin-Tyrrell-Washington District Health Department.
“This distance can create significant barriers to timely and accessible health care, particularly for urgent or chronic conditions,” Jenkins said.
ECU Health Edgecombe is roughly 30 minutes from the Wilsons’ home. Martin General would have been 10 potentially life-saving minutes closer if it were open. Which is the thing — if it were open.
The University of Wisconsin Population Health Institute (UWPHI) tracks preventable hospital stays, which are trips to hospitals, emergency rooms and urgent care centers that could have been avoided. Preventable hospital stays are costly, disproportionately impact historically marginalized communities and, long term, can negatively impact health and personal finances.
Nationwide, 2,666 hospital stays per 100,000 people enrolled in Medicare might have been prevented by outpatient treatment, according to the most recent data from UWPHI. Applying a racial filter to that data illuminates inequitable outcomes in Martin County. In 2022, white people in Martin County accounted for 3,495 preventable hospital stays per 100,000 people enrolled in Medicare. That number ballooned to 5,110 for Black people, who tend to earn less money and would have a harder time covering costs associated with ailments such as congestive heart failure and urinary tract infections that could’ve been treated with less financial expense in outpatient settings, where stays are designed for 24 hours or less.
Long time coming
And that’s the other thing — those times when longer-term, inpatient care is needed: Martin General reopening as a rural emergency hospital means it would not be a full-service hospital. For inpatient care, Martin County residents would go to ECU Health Beaufort Hospital, a good 45 minutes away in Washington, North Carolina. Incorporating the Beaufort piece into this would require a $150 million state investment to expand the facility, according to ECU Health’s proposal.
“We remain committed to advocating for state investment to build a sustainable regional system of care to support Martin, Beaufort and surrounding counties in the full budget,” ECU Health spokesperson Ashlin Elliott said.
“I’ll be advocating for it,” Willingham said. “If you don’t have the folks at the table advocating for something, it’s not gonna happen no matter what. No matter how bad it is, nobody is gonna sit up here who’s not advocating for it and say, ‘You know what? We need to go down there and help out Martin County because their hospital closed.’ That’s not gonna happen.”
Willingham’s been at it for a minute.
“We’ve been working on this for the last two and a half years, so this just didn’t happen,” he said.
In 2020, Congress established rural emergency hospitals in response to hospital closures in rural America. With Medicare covering costs, it was viewed as a solution for communities too small to support a full-service hospital. States individually had to pass legislation in order to offer rural emergency hospitals as health care delivery models, Willingham said.
“We pushed for that, and we got it,” said Willingham, acknowledging the limitations of Martin General not reopening as a full-service hospital. “It wouldn’t help them a whole lot if we just opened Martin General [as a rural emergency hospital] because there’ll be no beds there. So that’s why down in Beaufort we need to do the hospital down there, too, because they have the beds. It’s a little complicated.”
It’s a little expensive at $150 million to expand the Beaufort site, plus that $70 million for Martin General.
“With all this stuff that’s going on in Washington, [D.C.], we don’t know what they’re going to pull back and what they’re not going to fund,” Willingham said. “Like I said, it’s a little complicated.”
On July 4, the One Big Beautiful Bill Act was signed into law. Among the outcomes will be millions upon millions of individuals losing health care coverage through Medicaid, according to the Congressional Budget Office. The new legislation requires folks up to age 64 with no children or disabilities to prove they worked 80 hours each month in order to earn Medicaid coverage. Health care providers at hospitals can’t deny care to uninsured people. If those needing care are among the ones kicked off Medicaid, then hospitals would generate less revenue by providing uncompensated services. Some hospitals would close, especially facilities in rural communities.
Change gonna come?
Jeremy Collins is looking sideways at this.
“What I’m not hearing is a full-service hospital actually opening in Martin County,” said Collins, founder, president and CEO of Blackacre, an antiracism, innovation and connectivity development firm. Collins is converting the old Williamston High School campus into a community hub that would include a shared commerical kitchen and an aquatics center. The site was the former Williamston Middle School.
Collins isn’t altogether poo-pooing the ECU Health proposal. Reopening Martin General is part of the solution for better living in Martin County — but it has to reopen the right way, he said.
Jeremy Collins, founder, president and CEO of Blackacre
Centering community
Those disparities discourage Collins and give pause to Karida Giddings, access to health care program coordinator for North Carolina Black Alliance.
“You have to take it back to the community and understand, ‘OK, what are the health care needs that need to be fulfilled at the end of the day?’” Giddings said “If you have actual community members that require health care that needs inpatient care, which means longer stays, observations, a little bit more time with a doctor and not that 24-hour turnaround that comes with a rural emergency health center, then I think you have to make the decision that’s in the best interest of the community.”
No money, no hospital.
“The challenging part that we’re realizing right now is funding resources for health care are under attack,” Giddings said. “It doesn’t matter if it’s Martin County, Caswell County, or Anson County. It’s across the state. So what we’re seeing trickle down — not only from the federal level [but also] folks in North Carolina’s legislature following suit — is really a redetermination of how much money Medicaid is going to get. And for rural communities like Martin County, Medicaid is a core financial resource that holds up their health care infrastructure.”
Across the country, elected officials on both sides of the political aisle are worried about the impact Medicaid cuts could have on their constituents, as well as their political futures. Rural politicians should be really concerned, to hear Giddings tell it.
“There is a greater percentage of Medicaid beneficiaries in our rural communities,” Giddings said. “Prior to Medicaid expansion, a lot of these [rural] hospitals were struggling financially because they were providing uncompensated care. And you can only go on providing uncompensated care for so long before you start to get reimbursed or compensated for some of those services.”
No money, no hospital.
“It’s a business at the end of the day,” Giddings said.