Senate unveils health care bill
Medicaid, which accounted for 21 percent of Floyd Medical Center’s net patient revenue in 2016, is slated for cuts in the new bill.
The U.S. Senate unveiled on Thursday its much-anticipated legislation to unravel the Affordable Care Act.
Like the House bill, the Senate version — crafted in secrecy by 13 Republican senators — would slash Medicaid, which covers roughly 2 million Georgians; eliminate the legal requirement that almost everyone have insurance; and repeal taxes on wealthy Americans and the health care industry.
Senate Majority Leader Mitch McConnell, R-Ky., said he expects the bill to come to the floor for a vote as early as
next week, after the nonpartisan Congressional Budget Office has estimated its cost and impact.
“Republicans believe we have a responsibility to act — and we are,” said McConnell in a speech on the Senate floor.
The prospects for Senate passage are uncertain. The 48-member Democratic caucus is united in opposition, so Republicans can afford only two defections from their ranks. Vice President Mike Pence would cast any tie-breaking vote.
Medicaid reimbursements to Floyd Medical Center accounted for more than $84 million — 21 percent of its net patient revenue — last year, according to the hospital’s most recent audit, by Draffin & Tucker, LLC.
Both FMC and subsidiary Polk Medical Center qualify as “disproportionate share” hospitals, receiving increased compensation because of the high numbers of Medicaid and indigent patients they treat.
FMC officials did not want to comment Thursday on the Senate bill. A Redmond Regional Medical Center spokeswoman also said it would be premature to talk about the potential impact on the hospital, pointing instead to the Georgia Hospital Association.
The trade group released a statement saying it’s studying the bill, adding that it feared the legislation “will make additional devastating cuts to Medicaid and leave more Georgians uninsured and underinsured.”
“We urge Senators Isakson and Perdue to carefully consider the negative impact the AHCA will have on our hospitals’ ability to care for all patients and their communities,” said Earl Rogers, GHA president, in the statement.
The Senate legislation, like the House bill, would phase out the extra money that the federal government has provided to states as an incentive to expand
eligibility for Medicaid. Georgia is one of 19 states that have declined to expand Medicaid.
But the Senate bill would give those states a bigger window to pursue expansion than the House version.
It would, like the House measure, establish a cap on federal funding of Medicaid, allowing states to run their programs in a “block grant” format, beginning in 2021. The amount would grow more slowly than under the House bill, meaning bigger spending cuts overall.
Georgia political leaders, including Gov. Nathan Deal and state Sen. Chuck Hufstetler, R-Rome, have expressed concern about that conversion, if the federal spending is pegged to the states’ per-enrollee spending. Georgia ranks 45th among states in Medicaid spending per enrollee.
Senate vs. House
Citing the long-term Medicaid cuts, Bill Custer, a health insurance expert at Georgia State University, said Thursday that he expects the Congressional
Budget Office will estimate the Senate bill would leave more Americans uninsured than the House bill.
The CBO said the House overhaul would leave 14 million more people uninsured next year than under the current health law — known as the Affordable Care Act or Obamacare — and 23 million more in 2026. That’s about 700,000 Georgians, Custer estimated.
The Senate bill, like the ACA, would link the subsidies for individuals in the health insurance exchanges to their income. The House version used age as the primary determinant. But the subsidies would be based on coverage in a skimpier health care plan, and the income eligibility for these credits would be reduced. (The exchanges are designed for people who don’t get jobbased or government insurance.)
States would be allowed to change what qualifies as an essential health benefit, thus allowing coverage of maternity, mental health and other benefits to be dropped from policies.
But the Senate version would retain the ACA’s protections for patients with pre-existing health conditions, the Washington Post reported. And it would eliminate the House bill’s pathway for states to lift a ban on insurers’ charging higher premiums for people
with serious medical conditions, the Post reported.
As in the House version, the Senate bill would allow young adults to stay on their parents’ health insurance plan until they’re 26 years old.
The Georgia Budget and Policy Institute, in its study released Thursday, said the cuts in the House bill would reduce federal Medicaid funding in Georgia by $4 billion over 10 years. Hospitals in Georgia stand to lose an estimated $3.4 billion of that amount, with the state’s children’s hospitals taking a large portion of those reductions, the study said.
Laura Harker, GBPI health policy analyst, said Thursday that Georgia’s hospitals stand to lose even more from the Medicaid cuts proposed in the U.S. Senate bill.
“Under the Senate’s plan nearly 2 million Georgia children, seniors, veterans and people with disabilities still stand to lose vital health coverage through Medicaid benefits,” she told GHN.
Rome News-Tribune Staff Writer Diane Wagner contributed to this report. Georgia Health News, a nonprofit 501(c)3 organization, tracks state medical issues on its website georgiahealthnews.com.