Warren DeWitt has worked as a self-described “country doctor” for the past five decades.
Born and raised in Susquehanna County, he left the rural area and nine siblings behind for college in the big city.
He attended the University of Pennsylvania on a scholarship, graduating in 1969. DeWitt stayed in Philadelphia to attend medical school at Temple University. But he never questioned that he would return to his beloved hometown to practice medicine.
“I'm a country bumpkin, but I think I know what's right. You take care of your people,” DeWitt said.
He delivered babies at Barnes-Kasson Hospital in the borough of Susquehanna Depot. When a property went up for sale across the street, he bought it and converted the old house into a clinic in 1982.
The 77-year-old is retired from the hospital but still seeing patients once a week at his own Susquehanna Family Health Clinic.
His family makes up the bulk of his seven employees. Two of his daughters and his niece work there. His wife handled the clinic’s finances for years.
“It worked out well,” he said. “We were lucky, really, and we had patients that needed us. There's a great need here still. I was thrilled. I was busy. I was seeing patients. I just delivered babies. I thought, 'wow, this is what it means to be a country doctor.'”
The practice is a federally designated rural health clinic. After decades of family-run service, DeWitt is facing the possibility of closing the clinic’s doors for good due to recent changes to Medicaid.
He does not want to retire anytime soon.
“That would be my dream — die in the saddle,” Dewitt said.
But the clinic's future is uncertain as his family waits to see what happens as changes approved under President Donald Trump's "One Big Beautiful Bill Act" go into effect.
What is a rural health clinic?
There are just over 5,600 rural health clinics around the country, according to Sarah Hohman, the director of government affairs at the National Association of Rural Health Clinics. She estimates that there are about 79 in Pennsylvania.
“To be eligible for this specific designation, facilities have to be located in a rural area, as well as in a health professional shortage area or a medically underserved area,” Hohman said.
She explained that rural health clinics get reimbursed by Medicaid at a set rate for each Medicaid patient they see, while other healthcare facilities typically bill based on services provided.
“It's supposed to be a better reimbursement, a higher reimbursement than you would receive if you were trying to provide Medicaid services in a non-rural health clinic,” Hohman said.
Susquehanna Family Health Clinic had about 7,700 billable visits last year, according to Carrie DeWitt, Warren DeWitt’s daughter and the clinic’s director of operations.
“It's a way that we're funded, and a way that we can know what we're going to get from our Medicaid and Medicare patients,” she said. “That's not in jeopardy right now.”
But that doesn't mean there aren't challenges ahead.
How will changes to Medicaid impact rural health clinics?
Trump signed his ‘One Big Beautiful Bill Act’ into law on the Fourth of July, cementing major changes to Medicaid, the joint federal and state program that provides health insurance to 78 million Americans including nearly 3 million Pennsylvanians.
Those covered by the program include those with disabilities, low-income families and older adults.
The bill implements work requirements, with exemptions for certain groups including pregnant people, individuals with disabilities and caregivers. There will also be more frequent eligibility checks.
Carrie DeWitt said about 33% of the clinic’s patients are covered by Medicaid. Another roughly 35% are dual eligible for Medicare and Medicaid.
“The real concern that we have about this work requirement program is that we know that anytime you change or increase the paperwork requirements on a population that is already incredibly time-strapped, and ask them to do more to keep something, they're going to lose it,” she said.
KFF Health News found that over 10 years, federal Medicaid spending in rural areas is projected to decline by $137 billion. In Pennsylvania, that estimation is $5.5 billion.
KFF also found that work requirements would account for the most federal Medicaid savings and cause the largest increase in uninsured Americans.
'We will not be able to pay our bills'
The bill has a December 2026 implementation deadline. Carrie DeWitt said that’s not a lot of time for the state to figure out a reporting system or for rural health clinics to prepare for the potential losses.
An increase in uninsured patients is the real financial concern. As DeWitt’s sister Kathryn DeWitt Phillips, the clinic’s nurse practitioner, said, “I'm never going to not care for a patient because of lack of insurance.”
But the clinic also can’t absorb the cost of a higher uninsured population.
“Right now we have about 20% what we call private pay, but in reality, that means 20% that we write off for the most part, and so as that number creeps up, we will not be able to pay our bills,” Carrie DeWitt said.
“We're not in this business to make money. We're in this business to break even and continue to see patients," she said. "We are not making money here. We're keeping our doors open right now. That's what we do every month, and that's before these cuts happen.”
'We don't see fraud, waste and abuse here'
All of Northeast and Central Pennsylvania’s congressional representatives voted for the bill, including two Luzerne County Republicans — Rep. Dan Meuser, who represents Susquehanna County in Congress, and Rep. Rob Bresnahan, who has constituents that receive care at the clinic. U.S. Sen. Dave McCormick, a fellow Republican, also voted to pass the bill.
The DeWitts said they have been calling the legislators’ offices — at first to urge them to vote against the bill, and now for guidance. They said they’ve only spoken with staffers.
'My family has worked with Medicaid patients for decades, and we don't see fraud, waste and abuse here.'
— Carrie DeWitt
The family is upset about what they view as votes against the interest of constituents.
“I keep hearing about all the fraud, waste and abuse in this program, and I just don't see it,” Carrie DeWitt said. “I have worked with Medicaid patients for a very long time. My family has worked with Medicaid patients for decades, and we don't see fraud, waste and abuse here.”
DeWitt also said she invited the members of Congress to visit her family’s clinic.
“I want [legislators] to come meet us and hear how we help them and what my family does for them and has done for them for decades,” she said.
“I want to work on a solution together. How are we going to keep us here? How are we going to keep our patients here? How are we going to make sure that they continue to receive quality health care that they deserve? I would love to talk to them about that, because I hope they have some solutions.”
Meuser defends vote, changes
Meuser said the bill will support rural health clinics and that owners should not be worried about Medicaid losses.
“Concerns that the law will strip eligible patients of coverage are not grounded in fact,” Meuser said in a statement to WVIA News.
“The only individuals who could see their Medicaid coverage impacted are those enrolled in multiple states, individuals who do not qualify for the program under previous law, and, beginning in October 2026, those not lawfully present in the United States," he added.
Meuser said the law "creates a modest 20-hour-per-week work, training, or community engagement requirement for able-bodied adults without dependents to receive Medicaid."
"Even then, the law includes a grace period and full exemptions for seniors, pregnant women, individuals with disabilities, and caregivers," he said.
States have until Jan. 1, 2027, to implement the requirements, Meuser said, and the Secretary of Health and Human Services is authorized to grant waivers through Dec. 31, 2028, "giving states ample time to comply."
"Rather than cutting support, the One Big Beautiful Bill eliminates waste, fraud, and abuse in the broader Medicaid system and reinvests those savings into providers and patients who need it most," Meuser said. "This approach ensures that rural clinics and hospitals have the funding, flexibility, and forward-looking support necessary to deliver sustainable, high-quality care.”
Bresnahan, Meuser tout transformation fund
The law has a provision that would provide additional funding to rural healthcare through the Rural Health Transformation Program. The Trump administration said of the funding that it will provide, “unprecedented levels of federal assistance to rural and other vulnerable hospitals. The newly created Rural Health Transformation Program will deliver an investment of $50 billion over five years to transparently and efficiently transform rural health access.”
A Bresnahan spokeswoman highlighted the transformation fund.
“Representative Bresnahan is committed to ensuring rural health clinics have the resources necessary to serve their communities,” spokeswoman Hannah Pope told WVIA News in a statement. “Throughout the reconciliation process, he advocated tirelessly on behalf of Northeastern Pennsylvania to guarantee the region would see the funds included in the legislation’s Rural Transformation Fund, some of which will become available early next calendar year. Rep. Bresnahan will continue working to ensure these funds come home to Northeastern Pennsylvania.”
Meuser similarly touted the provision.
“The BBB [Big Beautiful Bill] provides significant funding for rural healthcare — allocating $50 billion over five years through the newly created Rural Health Transformation Program,” Meuser said.
“To put that into perspective, the Centers for Medicare and Medicaid Services (CMS) Office of the Actuary estimated that rural hospitals received $19 billion in total Medicaid support in 2024. Beginning in 2026, the new program will provide $10 billion annually in additional funding — a substantial increase offering states the tools and flexibility to modernize care delivery, stabilize operations, and better serve rural communities," his statement added.
"These funds will be distributed through detailed, accountable state-led transformation plans and are designed to support innovation, sustainability, and improved outcomes — rather than rewarding only large hospitals or those with high patient volumes, as previous programs often did,” Meuser said.
McCormick did not respond to WVIA’s request for comment.
KFF: Medicaid losses will exceed proposed $50B fund
Neither Meuser nor Bresnahan's offices responded to an additional request for comment regarding projections that the transformation fund will not be enough to fill the proposed gaps left by changes to Medicaid.
And the DeWitt family said it’s still not clear if clinics like theirs will be eligible for the funding.
“There's a part of this bill that gives money access to rural hospitals,” DeWitt Phillips said. “We're not a rural hospital. We're an independent rural health clinic. In my opinion, that wasn't enough money as it is for rural hospitals, but we won't see any of that.”
Hohman, from the National Association of Rural Health Clinics, warned that seeking money from the program could become competitive.
“There's a need in hospitals, there's a need in rural health clinics and a lot of other facilities. And so this is a small, small pot of money for the broad number of providers,” she said.
‘Generational care’ at Susquehanna Family Health Clinic
DeWitt Phillips sees her family's clinic as a staple in the community.
“It's truly generational care, caring for generations of other people,” she said.
DeWitt Phillips said the clinic’s longevity and her father’s ties to the community allow them to better care for their patients.
“Something that's always been important to us in our office is caring for patients as a whole,” she said. “A lot of the times that means caring for their family members as well, and ... generations of care.”
She sees 20 to 30 patients a day four times a week. One of her patients, Dorothy Wayman, has been a patient of Warren DeWitt since 1978. She followed him to the clinic when he opened it in the early 1980s. Now, he and his daughter take care of Wayman as well as her daughter and her grandchildren, all of whom Warren DeWitt delivered.
“This has been a good place. Half of the town of Susquehanna comes here to see them," Wayman said. "I know a lot of people that come here.”
Wayman travels eight miles to the clinic from her home in Hallstead. She isn't interested in having to go any farther than that for care.
“I just want them to leave it here, because I'm not traveling,” she said.
Besides Barnes-Kasson Hospital, which is across the street from the clinic, the closest hospitals are in Binghamton, N.Y., about a 30-minute drive, or Scranton, which is about an hour's drive.
“There are many people who can't travel these distances,” DeWitt Phillips said. “They're elderly, they don't have the means of transportation that many people have. It can be really difficult because of those barriers in transportation.”
Warren DeWitt fears grave health impacts if they or Barnes-Kasson had to close.
“A lot of people are going to be a lot sicker," he said. "Some people are gonna die.”
Jan DeWitt, Warren DeWitt’s niece and the clinic's psychiatric nurse practitioner, said her patients are scared.
“I see some people that have recognized that they may lose their health insurance, feeling really nervous,” she said. “I see other people who very well may lose their health insurance, and they're not really aware of that. That's also challenging for us, because we want to make people aware, but we don't want to scare them either."
"That's something we're navigating right now," she added. "How do we best support people and educate without scaring them or increasing stress?”
Jan DeWitt is one of a handful of psychiatric clinicians in Susquehanna County. She estimates that about 75% of her patients are covered by Medicaid.
“People are working,” she said. “If they are not working, it is not for a lack of trying. I have people all the time looking for work, and that's part of their stress. They might be working in the home, caring for elderly relatives. I don't really see anybody eating Bon Bons and then coming to see me and complaining about it.”
She’s seen a lot of change in the mental health industry over her career.
“Mental health, we have come a long way, and there's still a long way to go … Now we're going to just flip everything around, and we're going to fall behind,” she said. “Our ability to manage our well being and mental health is going to fall to the wayside. I'm very scared and concerned about it.”
Committed to patients despite federal funding uncertainties
The DeWitts are committed to serving their patients despite the uncertainty.
“I don't know where people will go if we don't exist anymore. All of our patients deserve quality health care, regardless of their ability to pay for it. [I] would love people to just really think about that,” Carrie DeWitt said.
The DeWitts want to assure their patients and community that they’re fighting to stay open. They’re currently working with healthcare advocacy groups to figure out how to best help their patients stay enrolled in their Medicaid plans as the changes loom.
“The choice is going to be for us,” Warren DeWitt said. “Should we see [uninsured patients]? Can we see them? We'll see them as long as we can, we'll do it as long as we can.”
DeWitt found a fulfilling career in caring for his community with his family at his side. He just hopes he can keep going.
“It warms my heart. They must have been watching me,” he said about his daughters and niece. “I'm proud of that. Very proud.”
