Congress must not forget rural health care needs
As Congress goes about the arduous task of repealing the failed Affordable Care Act, I would hope that they would keep rural hospitals in mind.
The ACA, or “Obamacare,” was an almost unbelievably complex piece of 2,000-page legislation that contained many details that need to be addressed as Congress works to untangle the mess it left our health care system. Obamacare clearly failed many people and organizations, but one such group that is often overlooked is the smaller communities and rural hospitals.
As a way to pay for this government takeover of health care, Obamacare included many new taxes and tax increases. But the other way it tried to pay for all the new subsidies was by cutting Medicare reimbursements to hospitals. Hospitals relied on these payments to cover the difference in what it cost to treat Medicare-eligible patients and what was actually paid. Other payments were made to the hospitals to cover the costs of caring for those who were not covered by insurance or Medicaid but still could not or would not pay their bills.
The theory was that Obamacare would put a bunch more people on insurance or Medicaid, and therefore the payments given to hospitals to care for the uninsured could instead go to paying for insurance subsidies. Of course it did not work out as well in practice as on paper, as Obamacare ultimately drove overall system costs up. So hospitals were still on the hook — and rural hospitals naturally took the brunt.
Now, as we look at ways to repeal this disastrous act, the question remains of what to do about those hospital payments. The most logical, fair and workable thing to do is to repeal the cuts along with the rest of Obamacare. As many of us said back in 2009 when it was being pushed through Congress, Obamacare was built on the backs of seniors, who of course were the ones who suffer most from Medicare payment cuts. This is as unacceptable now as it was then.
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