GOP debates hospital bailouts

Sunday, Feb. 9, 2014 1:19 PM
Last updated 5:54 PM
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ATLANTA — Republican governors scored easy political points by rejecting President Barack Obama’s plan to enroll more poor people in government health insurance.

Now Republican leaders in Georgia and Mississippi may be bailing out hospitals that will lose funding they would have gotten from Obama’s health care law. South Carolina’s leaders increased payments to some hospitals in a push to improve rural health, though the extra money likely placated hospital officials who might otherwise have pressured Republicans to adopt the Democratic plan.

The basic problem is simple: Obama’s overhaul is not being implemented as was planned. Its designers assumed that very few people would lack health insurance, meaning the U.S. government could reduce the payments it makes to hospitals for treating poor and uninsured patients. But after a U.S. Supreme Court ruling, 25 states refused to expand their government-funded Medicaid programs or are still debating it, leaving large numbers of the poor without health insurance. Without health insurance, those low-income patients cannot fully pay for treatment.

Hospitals in the holdout states still have to treat the poor, but they will get less money for doing it.

In Georgia, there’s concern about the finances of Atlanta’s Grady Memorial Hospital, a regional trauma center and safety net hospital for poor patients. About 60 percent of Grady’s patients are either uninsured or on Medicaid. Hospital officials project the federal spending cuts could cost it $141 million.

“You’re talking about a large number of uninsured, you’re talking about a Trauma I center,” said Chris Riley, chief of staff for Georgia Gov. Nathan Deal, “and you’re talking about a hospital that serves a very primary purpose, covers a lot of Georgia residents.”

Like his counterparts in other Southern states, Deal has rejected Obama’s plan to expand eligibility rules so people who cannot afford to buy subsidized health insurance plans on government exchanges can enroll in Medicaid, a public program that funds health care for the needy, aged, disabled and poor families with children. The federal government has pledged to pay the full cost of Medicaid expansion for three years, before lowering its share to 90 percent.

Georgia state Rep. Terry England, a senior Republican lawmaker tasked with drafting the budget, said he has discussed packages that could include payments to hospitals and run in the tens of millions of dollars. He called it cheaper than a Medicaid expansion. While discussions are ongoing, no formal proposal has been put forward.

Allowing a hospital such as Grady to slip into a crisis would be bad election-year politics. Deal faces two longshot Republican challengers in a primary this year, and the winner will run against Democratic state Sen. Jason Carter, the grandson of former President Jimmy Carter.

Other states are attempting partial fixes. In November, Mississippi Gov. Phil Bryant proposed sending an additional $4.4 million to make up for Medicaid cuts that were later delayed by Congress. He has chastised state lawmakers who tried last year pressuring him into expanding the Medicaid system.

“For us to enter into an expansion program would be a fool’s errand,” Bryant told The Associated Press in a December interview.

He also raised the concern — which has been echoed by other Republican governors — that states could be left with the tab if the federal government isn’t able to keep its promises on funding the expansion.

“I mean, here we would be saying to 300,000 Mississippians, ‘We’re going to provide Medicaid coverage to you,’ and then the federal government through Congress or through the Senate, would do away with or alter the Affordable Care Act, and then we have no way to pay that. We have no way to continue the coverage.”

South Carolina has taken a different approach. The state government raised the Medicaid reimbursements it pays rural, often financially struggling hospitals — from 60 percent of an uninsured patient’s bill to 100 percent. The change was part of a larger, $90 million effort — $48 million of it paid with state taxes — approved in this year’s budget. Gov. Nikki Haley’s administration called it a way to find and improve the health of South Carolina’s most vulnerable residents, focusing on rural areas. As a political benefit, it eased pressure on the same hospitals that would have the most to gain from a Medicaid expansion.

There is also a lack of consensus about how much expanding Medicaid would cost each state.

In Georgia, Deal’s budget officials estimate that expanding Georgia’s Medicaid system over a decade would cost the state government $2.8 billion. The first full year of an expansion would run about $48 million, or less than 1 percent of Georgia’s proposed state budget. Those costs would rise to nearly $498 million by 2023.

The estimates do not include the cost of covering people expected to enroll in Medicaid as they learn they are already eligible. They also exclude the cost of changes that will happen regardless of whether Georgia expands its Medicaid program or not.

However, the Georgia Budget and Policy Institute, which supports an expansion, estimates the costs of enlarging Medicaid may average around $35 million annually after taking into account new taxes that offset costs.

“What makes the Medicaid expansion so hard to compete with from an alternative standpoint is that it’s so much money,” said Tim Sweeney, the institute’s director of health policy.

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corgimom
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corgimom 02/09/14 - 02:57 pm
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GASP- Republican leaders

GASP- Republican leaders bailing out businesses?

Whoa!

If they do, then how can the GOP complain about Obama bailing out the car makers?

Or is it "do as I say, not as I do"?

rmwhitley
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rmwhitley 02/09/14 - 06:38 pm
0
0
I believe that if you're black, an illegal alien,
Unpublished

a criminal and/or a democrat or all of the above, you should be entitled to a yearly stipend of $150,000.00 from the age of 6 months. It should be retroactive to 1865 and that all Southern, conservative white folk should pay this on top of all medical bills incurred by the aforementioned people. In addition, all attorney fees should be charged directly to those riotus, obstructionist Tea Party affiliated souls who continue to ask that EVERYONE be responsible for their own living needs. How dare them for wanting accountability. I say, elect a moron like barack hussein obama to use his executive powers to procure these funds by execution, if necessary.

allhans
23688
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allhans 02/09/14 - 07:57 pm
4
1
I could be mistaken but

I could be mistaken but didn't GW approve the auto bailout before he left office and Obama only signed the check?

teaparty
11313
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teaparty 02/09/14 - 08:12 pm
3
4
"I could be mistaken but
Unpublished

"I could be mistaken but didn't GW approve the auto bailout before he left office and Obama only signed the check?"
The Obama administration over saw the bankruptcy of GM and screwed the bond holders who had 1st rights to reward the union. If a private company had did what the Obama administration did they would have went to jail.

Sophisticated
211
Points
Sophisticated 02/09/14 - 09:09 pm
3
7
When President Bush threw GM

When President Bush threw GM and Chrysler their first lifelines( with President - elect Obama's assent), he did so without congressional approve. After Congress voted specifically to prevent an auto bailout,Bush turned to the overly broad and harshly written TARP statue, which Congress has passed under extreme duress and threats from Treasury Secretary Hank Paulson that their failure to act would cause financial Armageddon. President Bush erred when he said he had abandoned free market principles to save the free market, what he had really done was write his successor a blank check. So, while it was President Bush who started the U.S. down this road, it was President Obama who took full advantage of this unlimited political line of credit,[and used] TARP as a justification for limit less executive meddling in economic decisions best left to private stakeholders. In that case, President Obama is correct to point out the differences between his and President Bush's approach to the ailing auto industry. In fact, President Obama was so determined to differentiate himself from his predecessor that he decided the measly $17.4 billion President Bush gave to Detroit was wholly inadequate. President Obama upped the ante and committed a full - blown $85 billion to the "rescue" of the auto industry. And what has been the result of saving the auto industry.

Little Lamb
46068
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Little Lamb 02/09/14 - 10:26 pm
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Dishonest Reporting

From the Associated Press:

In Georgia, there’s concern about the finances of Atlanta’s Grady Memorial Hospital, a regional trauma center and safety net hospital for poor patients. About 60 percent of Grady’s patients are either uninsured or on Medicaid. Hospital officials project the federal spending cuts could cost it $141 million.

Excuse me, but the decision by Georgia not to expand Medicaid eligibility will not result in federal spending cuts to Grady Hospital. No, the federal reimbursement payments will remain the same. Here, once again, the main stream media is trying to fool the people to get them to expand the federal government.

Associated Press is about as biased as you can get. Except McClatchey News Service is a bit worse.

corgimom
32616
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corgimom 02/09/14 - 11:09 pm
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No, LL, there will be

No, LL, there will be spending cuts. That was part of Obamacare.

The payments will not remain the same.

corgimom
32616
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corgimom 02/09/14 - 11:14 pm
4
3
"The Obama administration

"The Obama administration over saw the bankruptcy of GM and screwed the bond holders who had 1st rights to reward the union."

No, they didn't. GM's creditors had forced it into BK, the company had been declared insolvent, the bond holders would have gotten NOTHING unless they were bailed out.

When a corporation becomes insolvent, it ceases to exist and the bondholders hold worthless paper. They can file a claim in the BK court, but their chances of getting anything are pretty much zero.

GM was so BK that even by selling the assets, by the time the attorneys, accountants, and taxes were paid, the bondholders would've received nothing.

corgimom
32616
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corgimom 02/09/14 - 11:17 pm
3
2
Sophisticated, there weren't

Sophisticated, there weren't any more economic decisions to make by the stakeholders.

And the automakers are critical to our defense- America never, ever wants to be in the position of not being able to build defense weapons, machinery, and vehicles. It is not a normal industry, it is critical to our survival.

KSL
130050
Points
KSL 02/10/14 - 05:17 am
3
2
So the government stepped in

So the government stepped in and gave incentives, at taxpayers' expense, to car buyers to get them to buy GM cars, to heck with those taxpayers who wanted other brands for themselves.

Talk about crony capiltalism!

teaparty
11313
Points
teaparty 02/10/14 - 07:40 am
2
3
"No, they didn't. GM's
Unpublished

"No, they didn't. GM's creditors had forced it into BK, the company had been declared insolvent, the bond holders would have gotten NOTHING unless they were bailed out."
corgi, here is a couple articles after you are better informed we can have a discussion.
http://www.dailyfinance.com/2009/06/02/politics-trumps-seniority-for-bon...
http://nlpc.org/stories/2012/10/04/ask-gm-bondholders-and-delphi-retiree...

Bizkit
31545
Points
Bizkit 02/10/14 - 09:40 am
2
2
So the fed is going to punish

So the fed is going to punish states who didn't adopt an expansion of medicaid by reducing federal funding? That is discriminatory. So the reason we have a problem is because we refused to expand medicaid because of a concern that the fed will cut funding-which is already what they apparently have done -so Deals concerns must be real huh? So we can bail out these hospitals now or later if we adopt the expansion and then get left holding the bill. Which of course we will-the reason we are having problems in the state is because we are receiving less federal funding. Funny how the fed has cut all states funding but are suddenly willing to pay 100% of this expansion of Medicaid. Dang just shows you what they can really do if motivated.

Bizkit
31545
Points
Bizkit 02/10/14 - 09:48 am
3
2
The problem with the

The problem with the expansion of Medicaid is that the Middle class will be footing this expansion with massive new taxes-especially the next five years everyones taxes will increase significantly (so my accountant tells me). You can't tax the 1% enough to pay for squat. Strange how Obama tells the Middle class he is there friend yet he only seems to help the 1% get rich and then help the poor-the extremes. Once again he is lying to the middle class.

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