When the Obama administration was selling the benefits of the Affordable Care Act in 2010, the hospital industry agreed to accept a $155 billion decrease in Medicare payments over a decade. The administration assured hospitals that patients newly covered under the health-care law would make up for much of the loss.
The automatic federal spending cuts known as sequestration have sliced an additional 2 percent from Medicare reimbursement payments to hospitals this year. Beginning next year, many hospitals will also collect less money from Medicaid, the federal program that provides coverage for the poor, than they’d been promised when they signed on to the Affordable Care Act. The law required all states to expand their Medicaid programs to cover uninsured citizens who make too little to buy plans under Obamacare. But the Supreme Court ruled last year that states could opt out. Nearly half have chosen to do so, including Missouri, as Republican governors or GOP-led state legislatures have opposed the increased Medicaid spending.
This all means that 6 million poor Americans who would’ve been eligible for health coverage won’t get it; many of them will continue to walk into emergency rooms unable to pay for services that hospitals by law have to provide.
For-profit health systems whose patients are largely covered by private insurance may be equipped to absorb the losses. Rural and inner-city hospitals that run on thin margins and treat large populations of patients on Medicare, Medicaid, or without any insurance are struggling to make ends meet.
Missouri’s decision not to expand Medicaid is bad news for hospitals like GVMH. Expanded coverage under Medicaid was supposed to make up for the decrease in Medicare payments, that occurred as a result of the ACA.
U.S. hospitals have lost jobs in two of the last six months, according to the Bureau of Labor Statistics, a point hospital lobbyists stress in their rounds on Capitol Hill. There’s no chance that hospitals will get more money but at this point it’s important that we stop the cuts and it’s important that the government hold up its end of the deal. If not, access to health care services is going to be limited for some of the folks who need it the most.