Quantcast

Republicans proposed mini-bailouts for Ga. hospitals

By Ray Henry and Christina A. Cassidy AP Staff | 2/14/2014, 10:03 a.m.
In this Friday, Jan. 24, 2014 photo, a worker wheels beds through the emergency department at Grady Memorial Hospital, in Atlanta. In two years, federal payments to hospitals treating a large share of the nation’s poor will begin to evaporate under the premise that more people than ever will have some form of insurance under the federal health care law. The problem is that many states have refused to expand Medicaid, leaving public safety net hospitals there in a potentially precarious financial situation and elected officials facing growing pressure to find a fiscal fix. And in an election year, Democrats are using the decision by Republican governors not to expand Medicaid as a major campaign issue and arguing the hospital situation could have been avoided. Photo by David Goldman/AP.

ATLANTA - Republican governors scored easy political points by rejecting President Barack Obama’s plan to enroll more poor people in government health insurance.

Now Republican leaders in Georgia and Mississippi may be bailing out hospitals that will lose funding they would have gotten from Obama’s health care law. South Carolina’s leaders increased payments to some hospitals in a push to improve rural health, though the extra money likely placated hospital officials who might otherwise have pressured Republicans to adopt the Democratic plan.

The basic problem is simple: Obama’s overhaul is not being implemented as was planned. Its designers assumed that very few people would lack health insurance, meaning the U.S. government could reduce the payments it makes to hospitals for treating poor and uninsured patients. But after a U.S. Supreme Court ruling, 25 states refused to expand their government-funded Medicaid programs or are still debating it, leaving large numbers of the poor without health insurance. Without health insurance, those low-income patients cannot fully pay for treatment.

Hospitals in the holdout states still have to treat the poor, but they will get less money for doing it.

In Georgia, there’s concern about the finances of Atlanta’s Grady Memorial Hospital, a regional trauma center and safety net hospital for poor patients. About 60 percent of Grady’s patients are either uninsured or on Medicaid. Hospital officials project the federal spending cuts could cost it $141 million.

"You’re talking about a large number of uninsured, you’re talking about a Trauma I center,’’ said Chris Riley, chief of staff for Georgia Gov. Nathan Deal, "and you’re talking about a hospital that serves a very primary purpose, covers a lot of Georgia residents.’’

Like his counterparts in other Southern states, Deal has rejected Obama’s plan to expand eligibility rules so people who cannot afford to buy subsidized health insurance plans on government exchanges can enroll in Medicaid, a public program that funds health care for the needy, aged, disabled and poor families with children. The federal government has pledged to pay the full cost of Medicaid expansion for three years, before lowering its share to 90 percent.

Georgia state Rep. Terry England, a senior Republican lawmaker tasked with drafting the budget, said he has discussed packages that could include payments to hospitals and run in the tens of millions of dollars. He called it cheaper than a Medicaid expansion. While discussions are ongoing, no formal proposal has been put forward.

Allowing a hospital such as Grady to slip into a crisis would be bad election-year politics. Deal faces two longshot Republican challengers in a primary this year, and the winner will run against Democratic state Sen. Jason Carter, the grandson of former President Jimmy Carter.

Other states are attempting partial fixes. In November, Mississippi Gov. Phil Bryant proposed sending an additional $4.4 million to make up for Medicaid cuts that were later delayed by Congress. He has chastised state lawmakers who tried last year pressuring him into expanding the Medicaid system.

"For us to enter into an expansion program would be a fool’s errand,’’ Bryant told The Associated Press in a December interview.