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Tuesday, June 27, 2017

Senator McConnell alert- hospital workers instructed to oppose Republican health plan

"Ohio's acute care hospitals would see uncompensated care costs rise 76 percent from 2017 to 2016 under the House Republicans' AHCA version, while they would leap 165 percent in Kentucky,"- letter to the Cincinnati Inquirer. (Although Senator Mitch McConnell represents constituents in Kentucky, he's a frequent contributor to the Cincinnati Inquirer, a newspaper circulated in Kentucky)
Opinion in the Cincinnati Inquirer

There's no trouble cruising the opinion or "op-ed" sections of our nation's newspapers. Almost every one, large and small alike, have a juicy opinion worthy of blogging into cyberspace.

This particular letter describes how hospital workers in Cincinnati are being instructed to oppose the Republican moves to repeal the Affordable Care Act, aka "Obamacare". 

 As one pundit on the MSNBC morning TV shows said, people were largely unaware of how their individual health insurance policies were being administered when they had coverage under Obamacare, but they'll surely remember who will be taking it away from them, against their will.

By Anne Saker and Randy Tucker- Inquirer reporters

CINCINNATI, Ohio- Local hospital officials are watching with trepidation as the U.S. Senate works on its bill that would repeal parts of the Affordable Care Act.

Their concern: If thousands of Medicaid patients across Greater Cincinnati get thrown off the government health plan, hospital spending on millions of dollars of uncompensated care will explode and put renewed stress on budgets.

Much of the financial pressure would come from removing benefits from the roughly 697,000 Ohioans – including 59,406 people in Hamilton County – who got coverage from the ACA's Medicaid expansion, according to the U.S. Centers for Medicare and Medicaid Services.

At Cincinnati Children’s Hospital Medical Center, president and CEO Michael Fisher urged employees Monday to contact elected representatives and to campaign through social media against the Senate bill as harmful to children.

More: Senate health care bill would lead to 22 million more uninsured, CBO says

Cincinnati Children's is the 11th largest employer in Ohio and the second largest in the Cincinnati region, with more than 15,000 workers.


“We do not believe this legislation, as written, will meet the health needs of all kids,” Fisher’s letter said. “Because kids don't vote, they often don’t have a voice in politics. They rely on us to speak up for them.”

Officials of UC Health, the region’s academic health center, worked on a statement about repeal efforts to go to employees Tuesday, said spokeswoman Kelly Martin.

UC Health’s community benefits reports – annual statements, required under the ACA, on how much care hospital systems give away or subsidize – illustrate the staggering amounts of money potentially involved.

In 2012, before the ACA fully took effect, UC Health provided $48.2 million in charity care and covered $16.1 million in unpaid Medicaid costs, reports on UC Health's website show. But in 2015, with the ACA in full effect, UC Health spent $3.4 million in charity care and $7 million in unpaid Medicaid costs.

Uncompensated care in 2015 at Cincinnati Childen's included $216 million in free or discounted services; the comparable figure for 2012 wasn't immediately available.

Nationwide, uncompensated care dropped 22.2 percent nationally from 2012 to 2015, according to the American Hospital Association. Hospitals saved a total of $6.2 billion on uncompensated care, including charity cases and bad debts (when bills for services were unpaid).

The drop occurred in the 31 states, including Ohio and Kentucky, that expanded Medicaid benefits, according to a recent report for the Commonwealth Fund. Costs essentially held steady in the states that declined the expansion.

Ohio's acute care hospitals would see uncompensated care costs rise 76 percent from 2017 to 2016 under the House version, while they would leap 165 percent in Kentucky, a separate Commonwealth Fund report concluded. The report, which noted the Senate bill cuts Medicaid more deeply than the House version, say operating margins would drop 1.8 percent in Ohio and 5.6 percent in Kentucky.


At Mercy Health, spokeswoman Nanette Bentley declined to describe the impact of an ACA repeal on Ohio’s largest health-care provider and its fifth largest employer. But she said that in Cincinnati, 16.8 percent of Mercy Health patients now are on Medicaid, and the ACA “provided for preventive health coverage to those in need of care who couldn’t previously access it.”

Fisher said in his letter to employees, “We’re very concerned that the proposed Senate bill (as did the AHCA House bill) will do harm to most of the children who depend on Medicaid.”

Fisher said more than 45 percent of Cincinnati Children’s patients, or about 133,000 children, are on Medicaid, and the Senate bill could cut services for children by more than $40 billion over 10 years. In Ohio alone, he said, “Medicaid funding for kids could drop as much as 17 percent or $1.6 billion over that same period.”

Like Fisher of Cincinnati Children’s, Mark Clement, TriHealth’s president and CEO, urged his system’s employees to speak to lawmakers about the Senate bill.

“Every health organization in the country is opposing it and has entered into advocacy to approach legislators, approach senators,” Clement said. “Between now and 2026, more than $5 billion in federal funding will be reduced to support the Medicaid program. That will impact every healthcare provider. It will impact access, and ultimately the health of the community we are entrusted to serve.”

Despite years of complaints about the ACA, the prospective changes to the law proposed this year have ignited fears that millions of lower-income and disabled adults and children, including thousands of Greater Cincinnati residents, could lose coverage from Medicaid.

The Ohio Hospital Association has been vocal in opposition to the repeal measures now in Congress. John Palmer, director of media and public relations, said the association estimates the Senate’s version of ACA repeal could trigger a shortfall in Ohio’s Medicaid program that could approach $1 trillion over 10 years.

In Dayton, officials at Premier Health, which includes Atrium Medical Center in Middletown, said in a statement that the proposed cuts “would have a staggering impact on Premier Health, Ohio’s hospitals and the U.S. health care system, and would severely limit hospitals’ delivery of care and their economic impact."

The statement noted the House version of the repeal, similar to the Senate’s, would cost Premier $862 million in Medicaid reimbursement over the next decade. The cuts also would boost Premier's uncompensated care costs by $182 million.

Officials at CareSource, Ohio's largest Medicaid managed-care provider, also based in Dayton, said the repeal efforts would set back years of progress at a critical moment when Ohio is struggling against the opioid epidemic.

"Lives are at stake,” said president and CEO Pamela Morris. "In 2016, Medicaid paid for 24 percent of the medications used for treating opioid addiction. In the five states with the highest opioid overdose mortality rates – Ohio being … a standout nationally – Medicaid covered 41 percent of opioid treatments.''

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