(Radio Iowa) – Two U.S. senators from neighboring states say rural hospitals will take a financial hit if tens of thousands of residents in Iowa, Minnesota and Wisconsin lose Affordable Care Act subsidies. The federal tax credits available to middle income Americans buying health insurance on the Affordable Care Act Marketplace will expire December 31st if congress doesn’t vote to extend them. Democrat Amy Klobuchar, a U.S. Senator from Minnesota, says the loss of those tax credits would be a major blow to rural America.

“As one of my soybean farmers recently told me, this is a perfect storm of ugly,” Klobuchar said, “between the tariffs, between the input cost increases because of the tariffs, because of the other problems that have been out there for a while for our farmers with the cost of land and the like and then these health care cuts.” Democrat Tammy Baldwin, a U.S. Senator from Wisconsin, says if congress fails to take action, many rural Americans won’t be able to afford the spike in their premiums and will be uninsured next year.

“Rural hospitals are teetering on the edge,” Baldwin said, “and they may face the options of either closing vital services like delivery and mental health services or close all together, meaning people have to drive much further for their health care.” In 2009, the Affordable Care Act passed congress solely with Democrats’ votes and Republicans have never voted for the subsidies that are expiring — arguing problems in the law must be addressed. Baldwin says congress can’t resolve the structural issues in the health care system between now and December 31st, when the tax credits for 22 million Americans expire.

“More than one in four farmers nationwide relies on the Affordable Care Act for (health insurance) coverage,” Baldwin said, “and the expiration of these tax credits will be just yet another blow.” Klobuchar says rural hospital officials are bracing for more uninsured patients who often require more expensive care because they’ve quit taking expensive prescription drugs and skip regular check-ups. “If people start dropping their health care because they simply can’t afford it, then they have uninsured people sadly showing up in emergency rooms,” Klobuchar said. Klobuchar and Baldwin made their comments during an online news conference.

South Dakota Senator John Thune, the top Republican in the U.S. Senate, has said Republicans are willing to discuss extending the tax credits — once more Democrats in the Senate join Republicans and vote to reopen the federal government.