Chuck Edwards: “Failures of Obamacare” Led to Mission’s Decline in Care

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Written by Tom Fiedler, Asheville Watchdog.

Congressman Chuck Edwards said he is “acutely aware of the problems” that patients have had at Asheville’s Mission Health since the hospital system was purchased by HCA Healthcare, but said he sees no need for his office or the federal government to offer a solution.

In an interview with Asheville Watchdog on Friday, January 26, the Republican congressman blamed the documented decline in patient care since HCA purchased the non-profit Mission Health system in 2019 for $1.5 billion on “the failures of Obamacare.”

The Affordable Care Act, colloquially called Obamacare, became law in 2010 under then-President Barack Obama over strong Republican objections with the goal of enabling millions of low-income Americans to obtain medical care. Edwards said the law “imposed enormous regulations on hospitals” and forced many into financial distress, including Mission in Asheville and its affiliated Transylvania Hospital in Brevard.

He said the directors of the Mission Health system recognized the non-profit couldn’t sustain the existing level of services with reduced income “and were forced into a situation where they had to sell” to the larger, for-profit conglomerate based in Nashville.

An investigation late last year by the North Carolina Department of Health and Human Services found that conditions at the hospital have deteriorated so greatly that they posed “immediate jeopardy to patients’ health and safety.” Mission must correct the deficiencies quickly or it may lose its ability to participate in Medicare and Medicaid, the federal and state programs to subsidize Medicare for older Americans and the poor.

In December, North Carolina Attorney General and Democratic gubernatorial candidate Josh Stein filed a lawsuit against HCA and Mission, alleging they have violated the asset purchase agreement regarding cancer care and emergency services at the hospital.

Among the problems documented by The Watchdog are the massive exodus of physicians and other medical professionals, nurses’ concerns about transfer procedures in the emergency department and a decline in the level of cancer care. This week The Watchdog reported that a recent academic report found that the hospital’s charity care has declined since the sale.

In the interview in his Hendersonville office, Edwards said that HCA isn’t without responsibility for its failure to prevent or arrest this decline.

“Mission Health, now HCA, has made some really bad mistakes in the transition,” Edwards said. “They didn’t understand the culture”  of Western North Carolina, which had become accustomed to a less “industrial” form of healthcare delivery.

“Sometimes the doctor doesn’t even look up from a computer screen” to speak with a patient,” Edwards said.

The corporate culture also alienated hospital staff, “and they saw physicians, providers, and clients begin to rebel,” he continued. “And now they will pay the price.”

Edwards said his office has been “inundated” with complaints from constituents about conditions at Mission, but added, “I don’t see the federal government having a role in it…. I do believe that most people would demand high-quality care, but it’s not up to the government to make this demand. It’s up to patients.”

The congressman said he doubted that HCA would seek to shed the controversy by selling Mission to a rival operation or back to the community.

“I would believe HCA would be more interested in protecting the investment they’ve already made in Western North Carolina and take the steps necessary to provide care,” he said.

HCA Healthcare currently owns 186 hospitals and more than 2,000 health-care facilities in the United States and Great Britain.

Asheville Watchdog is a nonprofit news team producing stories that matter to Asheville and Buncombe County. Tom Fiedler is a Pulitzer Prize-winning political reporter and former executive editor of The Miami Herald. Email [email protected]. To show your support for this vital public service go to