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Senate bill bad for Tennessee hospitals
The U.S. Senate may vote this week on the Better Care Reconciliation Act, which is a revised version of the House-passed American Health Care Act . It would mean an additional 22 million Americans without health insurance. But the President of the Tennessee Hospital Association says the proposal would put Tennessee hospitals at risk. Alan Watson says it is important to guard against changes that ultimately are more costly and do not work as well for patients and the providers who care for them. He says the Hospital Association has worked to find ways to improve access to care, lower the cost of care and improve quality. But the Senate bill does not meet these longstanding goals. Watson says hospitals oppose the Senate proposal for a number of reasons. That are based on past experience in Tennessee, rather than projections of what might happen. Currently, when Tennessee spends state dollars on services for Medicaid enrollees, the federal government provides a roughly two-to-one match on that investment, but the proposal establishes a maximum limit on federal funding for state Medicaid costs. That would place responsibility for unanticipated increases in the costs of caring for individuals enrolled in TennCare directly on the state of Tennessee. Unforeseen crises like the current opioid epidemic in Tennessee, resulting in babies born with neonatal abstinence syndrome, can significantly increase program costs. In addition, economic downturns, public health emergencies or unexpected nursing home needs of seniors are all instances where Medicaid ensures access to care when all else fails. In recent years, when TennCare and state government faced funding challenges, cuts to provider payments, changes to enrollee benefits, and caps on program enrollment have been the solution, which jeopardize the financial viability of already struggling hospitals. Watson points out that medical care is not free to hospitals or the communities they serve. Some of Tennessee’s most vulnerable hospitals — including many in rural areas — may need to eliminate services or close if unreimbursed costs exceed limited resources. Hospitals have many concerns with the proposal, but the dramatic reduction in Medicaid funding, places the health care of Tennesseans and the viability of the state’s hospitals in great peril, argues Watson.
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