As Martin General Hospital sat shut in Martin County, N.C., residents described the practical consequences of being unable to rely on local emergency care—long drives, stretched distant ERs, and uncertainty about what would have happened “that night” before the nearest higher level of treatment was so far away.
Debra Pierce, whose brother Stanley Sears died after a heart attack in the county, said emergency crews from a neighboring town worked on Sears for about half an hour but could not revive him for the long drive to the closest hospital. Pierce told KFF Health News that she has no way to know whether Sears “could have been saved,” because the county no longer has the type of care that would have been available before the closure.
Martin County’s limited emergency infrastructure has also become part of the political story around Republicans’ rural health push tied to the One Big Beautiful Bill Act. The NPR report said the rural health fund has drawn high anticipation, with Republican candidates casting it as a lifeline for rural communities as they campaign ahead of competitive midterm contests, including the House race covering Martin County.
County Manager Drew Batts said the fund does not address the county’s immediate need. He said in April that “the $50 billion is not something that is specifically going to help our situation” and that it would not help the county reopen the shuttered hospital. Batts said Martin County does not have paramedics on its ambulances and that it can take 20 miles or more to reach nearby emergency rooms that are often overcrowded.
Martin General Hospital closed abruptly in 2023, leaving behind what the report described as a gutted healthcare system. The closure surprised employees and patients, and local officials said Quorum Health—an operator of the county-owned hospital—did not notify them before filing for bankruptcy; a Quorum spokesperson, Lisa Anderson, said the company had told county commissioners about the hospital’s ongoing financial challenges.
Since the closure, county taxpayers have poured money into maintaining the site, Batts said, and the county is now considering spending at least $1.5 million to create two higher-level paramedic units with quick-response vehicles equipped with tools including electrocardiogram capability. Pierce said she wants the county to add paramedics and reopen the hospital, describing what she called “answered prayers happening every day” while saying, “So, we can only pray and hope.”
In the wider Greenville region, ECU Health—described in the report as the largest health system and a de facto safety net for multiple counties—has been handling patients who previously might have gone to Martin General. Brian Floyd, ECU Health’s chief operating officer, said the emergency-care gap had already cost lives and that the lack of nearby options leaves residents with nowhere to go when emergencies arise.
The report also described how delays show up in day-to-day ER operations. It cited ECU Health’s reported increase in its daily ER visits after the closure and said staff told one family to wait outside due to capacity issues; it also described security procedures tied to capacity notices near the Greenville emergency department. ECU Health spokesperson Brian Wudkwych said the ER wait times are tied to shortages, and Floyd said many rural patients arrive with multiple chronic conditions that require longer visits.
ECU Health has also sought a path to reopen Martin General as a rural emergency hospital. The report said ECU Health signed a letter of intent and that under the deal the county would pay to refurbish the hospital, while the North Carolina General Assembly would need to provide ECU Health $210 million for a construction plan that includes an inpatient tower at Beaufort Hospital. Floyd said federal money from North Carolina’s rural fund cannot be used to reopen Martin General.
The report framed the rural health fund as an election issue in the House race covering Martin County, where the closure and the proposed funding have become campaign talking points. It said the rural health fund was added in 2025 to help win votes for the One Big Beautiful Bill Act, which reduces federal Medicaid spending by more than $900 billion over a decade and is projected to hit rural hospitals and clinics especially hard, according to rural health executives in the report.
In campaign materials and responses, the contest has sharpened into arguments about who opposed or supported the bill and the rural funding request. Republican Laurie Buckhout’s campaign spokesperson Stephen Gallagher said Martin County “lost its hospital” on Rep. Don Davis’s watch and that Davis opposed “the funding meant to help communities like it.” Davis, a Democrat seeking a third term, said in support of North Carolina’s rural health fund application that the money is “essentially putting a band-aid on a much, much broader situation that needs dire help.” During Capitol Hill testimony, ECU Health CEO Michael Waldrum said the system expects to lose a billion dollars over the next 10 years from the looming Medicaid cuts.
Meanwhile, families living with the closure describe a cycle of seeking care far away when emergencies arise. The report included accounts of long waits and abrupt departures from ERs when capacity pressures mount, along with residents saying they had not even heard of the rural investment campaign message because their immediate experience has felt more like the removal of services than the arrival of help.