As a travel nurse, I’ve worked in hospitals in different communities and seen firsthand what happens when more people struggle to get the care they need.

I’ve seen hospitals fill up. I’ve seen patients wait in crowded emergency departments, nurses stretch themselves thinner and health care teams make impossible choices about where limited resources are needed most.

And increasingly, I’m seeing the same thing happen for a reason that has nothing to do with whether patients are sick enough to need care. People are struggling to afford it in the first place.

For too many North Carolinians, getting care now means traveling farther, waiting longer, paying more or going without it altogether.

In North Carolina, an estimated 234,483 people have already lost Medicaid, CHIP or ACA coverage they relied on to see a doctor. That includes an estimated 69,801 people who have lost Medicaid or CHIP coverage and 164,682 people who dropped ACA coverage after premiums increased.

Those numbers are enormous. But when you work in a hospital, you understand that they aren't really numbers. They are people.

They are the people who show up at the emergency department after putting off an appointment. They are patients who ration medications or live with symptoms longer than they should because they don't know how they will pay for another medical bill. They are parents making calculations no family should have to make: Do I pay the insurance premium, or do I pay the rent? Do I fill the prescription, or do I put groceries on the table?

And the pressure doesn't stop with patients. Health care workers feel it, too.

As of August 2026, 22 hospitals, clinics and nursing homes in North Carolina have closed, announced cuts or are at risk of doing so. Health care leaders are warning about the consequences of difficult financial decisions, including reductions in services, maternity care and critical care, as well as layoffs.

When you work in a hospital, you know what a lost service can mean.

A critical care unit isn't simply a line on a hospital budget. It is where someone goes when their life hangs in the balance.

A nurse who is laid off isn't just a position removed from a spreadsheet. It's one less person available to hold a patient's hand, catch a change in their condition or help a frightened family understand what is happening.

North Carolina hospitals and clinics are already facing an estimated $437 million loss in funding and a projected 3.3% increase in uncompensated care demand. North Carolina hospitals are also expected to lose an estimated $35.4 billion over the next decade because of Medicaid cuts.

They mean fuller waiting rooms. They mean longer waits. They mean staff trying to do more with less. They mean communities wondering whether the hospital they depend on will still be there when they need it.

And for rural and underserved communities especially, losing a health care provider can change everything.

If the closest maternity ward closes, a pregnant woman may have to travel much farther to deliver her baby. If a clinic shuts its doors, a patient may have to take time off work and drive hours for an appointment. If a hospital cuts a service, a medical emergency can become a race against distance and time.

I've watched health care workers show up anyway. But compassion cannot substitute for access.

I believe people should be able to see a doctor before a problem becomes an emergency. I believe parents should be able to take their children to the hospital without wondering whether they can afford it. I believe older adults should be able to get the care they need close to home. And I believe health care workers should have the staffing and resources necessary to provide safe, compassionate care.

I've traveled across North Carolina and worked alongside people who dedicate their lives to caring for others. What I've seen has convinced me of one thing: when access to health care is weakened, the consequences don't stay on paper.

They reach the hospital. And eventually, they reach all of us.