Provider cuts still an option under any debt deal
Provider cuts still seen as option in debt deal
Members of Congress are giving providers no promises that they will avoid cuts or increased costs under any debt deal, even as many rank-and-file legislators say they understand the economic pressures on the healthcare sector.
A series of proposed cuts in provider payments have emerged from ongoing negotiations toward an agreement that would lift the federal government’s debt limit while reducing future deficits. The government is expected to reach its statutory borrowing limit by Aug. 2, requiring a congressional vote lifting it.
Republicans have generally called for spending cuts equal to any increase in the debt limit, while Democrats have urged various combinations of cuts and new taxes.
Although much of the discussion between the White House and congressional leaders remains secret, one summary of about $350 billion over 10 years in healthcare cuts discussed during the nearly seven weeks of talks was leaked this week.
Members of the Obama administration and congressional leaders have remained tightlipped about any specific cuts under consideration. And rank-and-file members of Congress have told Modern Healthcare and provider advocates recently that they cannot confirm any of the specific cuts under discussion because their leaders have not revealed any specific plans or proposals to them.
“In both Republicans’ and Democrats’ offices, the lack of anyone having any detailed knowledge was the same everywhere,” said Scott Malaney, CEO of Blanchard Valley Health System in Ohio, who visited Ohio’s congressional representatives last week.
That has left many providers and their advocates to focus on the leaked list of healthcare cuts discussed in earlier phases of deficitreduction negotiations that President Barack Obama asked House Majority Leader Eric Cantor to compile.
A range of provider cuts were included in the “areas of commonalities” list attributed to the Biden talks. Those included $100 billion in reduced spending by standardizing Medicaid federal medical assistance percentages, or FMAP, program; about $50 billion in payment reductions and co-payments for skillednursing facilities and home health; and about $14 billion in savings from changes in Medicare’s rural hospital payments. Other proposed cuts include up to $26 billion from the government cutting back on reimbursements for unpaid hospital debts and $4 billion in lowered federal Medicaid payments to hospitals that treat an especially high percentage of low-income patients.
The list provided no specifics on the structure or implementation of the program changes.
Those and other proposed cuts have drawn concerns from providers and their advocates, who have launched increasingly aggressive outreach to members of Congress over the debt talks in recent weeks.
“Several members of Congress expressed great concern” about the impact of potential provider cuts, Hugh Tilson, senior vice president of the North Carolina Hospital Association, said about discussions he had last week with federal legislators.
However, lawmakers stopped short of promising to vote against any deal with provider cuts, according to interviews with a half dozen hospital executives and advocates who last week visited Capitol Hill.