Hospitals and Physicians Don’t Have Time to be Dealing with Political Squabbles over Medicaid Expansion

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MDC-thumb1The politicization of healthcare has always placed providers on edge, but Mark Niquette and Brian Chappatta of Bloomberg report the latest battle over Medicaid is simply something physicians and hospitals don’t have the time to be dealing with.

One northwest Ohio rural hospital executive, Phil Ennen, told Bloomberg “he’d be out $1.3 million a year and struggle to stay independent if business groups and Governor John Kasich can’t persuade fellow Republicans to expand Medicaid to cover more poor people under President Barack Obama’s Affordable Care Act.”

With the only emergency cardiac catheterization lab between Toledo and Fort Wayne, Ind., Niquette and Chappatta write, Ennen said he doesn’t “have any time to be political about this. I’m going to have people walking through our door needing care who should have a source of payment and won’t, and that’s frustrating.”

It’s hard to write a post of this emotional magnitude without getting political, so here’s the simple fact, with no offense intended: Tea Party Republicans are behind this blockade. Maybe there are readers out there who believe this is a good thing; maybe not. But as the article relates, states in which Medicaid has been expanded, not blocked, “are already enjoying lower borrowing costs.”

The political situation, however, breaks down as follows: “Twenty-five states and the District of Columbia are proceeding with Medicaid expansion, including eight with Republican governors. Twenty-two aren’t and debate is continuing in New Hampshire, Ohio, and Tennessee, according to the Kaiser Family Foundation, a nonprofit group that studies health in Menlo Park, Calif.”

Furthermore, “If all states participated in the Medicaid expansion, hospitals would see a $12.5 billion spending boost in 2014, according to an analysis by Bloomberg Government. About $7.8 billion, or 63 percent, won’t be spent in the 25 states that have so far decided not to expand. The increased spending in Ohio would be $458.4 million, the analysis said.”

Should Ohio not expand, Mike Abrams, president of the Ohio Hospital Association, described a scenario in which “Ohio hospitals will lose $7.4 billion during the next decade from reduced reimbursements…Hospitals that are the largest employers in 78 of Ohio’s 88 counties may fire employees or close.”

Yet this is the situation we find ourselves in, with open enrollment around the corner and the Affordable Care Act on the brink of full implementation. When you’re overhauling a system, it helps to not have riffs within the foundation. It helps to at least agree that impoverished people deserve healthcare, too, and that providers deserve to have the needed funds to administer that care.

But is that the case here? Or are the folks, most of them patriotic and well-meaning, being guided by misinformation that is counterproductive to their case? As healthcare leaders, what is your opinion on the political situation surrounding Medicaid expansion and healthcare reform in general today?

-by Pete Fernbaugh

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