Hospitals Worry About GOP’s Plans for Medicaid

Cuts could affect bottom line and compromise patient care, spokesman says

Some health care providers are worried about what changes to Medicaid under President Trump will mean for their bottom lines and the patients they serve. In Connecticut, for example, the Connecticut Hospital Association is warning that “hospitals’ fiscal stability and sustainability, as well as patient access to care, will be compromised” if the Patient Protection and Affordable Care Act (PPACA) is repealed and cuts in Medicaid payments to hospitals remain in place.

That is especially true for Hartford Healthcare, which owns five acute-care hospitals and two mental hospitals, according to an article in the Hartford Courant.

Dr. Rocco Orlando, chief medical officer for the Hartford Healthcare system, said the hospital’s leaders are concerned about the prospect of the federal government no longer paying most of the cost of expanding eligibility for Medicaid.

“It would have a profound impact; it’s very much front-of-mind,” he said.

This year, Connecticut will need to come up with approximately $61 million for a Medicaid expansion that was part of the PPACA.

But the bill that could come due in 2019 or 2020 if the PPACA is repealed is far more worrisome. Currently, the federal government pays 98% of the $1.2 billion annual cost to insure 201,000 poor adults in Connecticut who earn too much to qualify for Medicaid. Under the PPACA, the federal share was supposed to gradually shrink until it was a 90% match—far more generous than the 50% match Connecticut receives for another 555,000 residents covered by Medicaid.

Vice President-elect Mike Pence recently promised to repeal the PPACA “lock, stock, and barrel” early next year, but congressional leaders are saying there will be a two- or three-year transition period before the replacement takes effect.

Dr. Tom Price, President-elect Trump’s selection to lead the Department of Health and Human Services, which oversees Medicare, Medicaid, and the PPACA, would like to move from a guarantee of health care to the poor to a set amount of spending per person. Instead of sharing the cost of hospital or nursing-home bills with states, the government would send a block grant and let the states decide what to do with it.

Orlando said his colleagues are concerned about this approach, “particularly if the move to block grants has an agenda to reduce Medicaid.”

Last year, Price wrote in a letter that Medicare, Medicaid, and Social Security “are binding seniors and low-income families to a costly, centralized health care strategy that intrudes on the personal decisions of patients and their doctors, promising retirement income the government cannot provide [and] trapping the disadvantaged in a web of welfare programs that draw beneficiaries into long-term government dependency."

Source: Hartford Courant; December 20, 2016.