Vice President Joe Biden announced the agreement at the White House, with administration officials and hospital representatives at his side. “Reform is coming. It is on track; it is coming. We have tried for decades to fix a broken system, and we have never, in my entire tenure in public life, been this close,” Biden said.
The deal also allowed hospitals to limit the damage to their budgets. The Obama administration agreed to forgo bigger cuts under discussion, the American Hospital Association said in a memo to members.
Hospitals also won an understanding that if the Finance Committee’s legislation includes a public health insurance plan, it would reimburse hospitals at above the rates Medicare and Medicaid pay, which hospitals have long complained are insufficient.
The concern is, said Dr. James Rohack, director of the Center for Healthcare Policy at Scott & White Healthcare, if the model used to develop the program to cover the uninsured is based on the Medicare reimbursement rates it will put pressure on private employers to pick up the difference, Rohack said.
“That becomes very difficult, especially for small employers, to afford that premium,” he said.
It also will affect hospitals, who will find it more difficult to invest in technology and pay wages that are fair for support personnel, Rohack said.
“It’s just a reminder that just because you have health insurance, if the insurance isn’t adequate you haven’t really moved the ball down the road where you wanted to,” he said.
The federal government now pays hospitals to care for the uninsured, Rohack said.
If the 47 million uninsured Americans get coverage through health care reform, those federal dollars paid to hospitals would be saved, he said.
However, hospitals in Texas and other states along the border need to remember programs that develop from this health care reform initiative are for American citizens, Rohack said.
“There will still need to be a disproportionate share apparatus to cover those who don’t have health insurance, but also aren’t eligible to get it from any other mechanism,” he said.
“The EMTALA law (Emergency Medical Treatment & Labor Act) says that a hospital has to care for someone regardless of their immigration status,” Rohack said.
There is no definitive total on the number of illegal immigrants in Texas, he said, but estimates run as high as 3 million.
Some of the projected savings touched off a controversy within the hospital industry.
About $50 billion would come from reducing federal payments hospitals receive for providing care to uninsured and low-income patients. Those payments are now made through the Medicare and Medicaid programs.
But public hospitals and children’s hospitals, which serve many low-income patients, said such cuts would harm local communities. The National Association of Public Hospitals and Health Systems and the National Association of Children’s Hospitals, which were not directly involved in the talks, said in a joint statement: “Such reductions could severely damage safety net providers if not carefully crafted.”
“This is essential funding that supports trauma centers, burn care units and medical training,” said Melissa Stafford Jones, president of the California Association of Public Hospitals.
House Republican Leader John Boehner of Ohio criticized the hospital deal, saying it was negotiated out of public view. “The administration and congressional Democrats are literally bullying health care groups into cutting back-room deals to fund a government takeover of health care,” Boehner said in a statement.
Telegram staff writer Janice Gibbs and writers Ricardo Alonso-Zaldivar, David Espo, Erica Werner and Alan Fram contributed to this report.
