Hospital leaders must deal with upcoming changes

TOUGH DECISIONS

By Brian Tabor

Health care leaders across the state are closely following the action in Washington D.C. on “repeal and replace” of the Affordable Care Act.

Given the recent announcement that two insurers will not offer coverage in Indiana through the ACA marketplace for 2018, the need to stabilize this market is more urgent than ever. More than 150,000 Hoosiers could be without options if this trend continues.

But while Indiana’s hospital leaders support swift action to address this problem and also desire other significant changes to the ACA, there are major concerns with how the Medicaid program may be affected by the current proposal before the U.S. Senate.

Indiana has proven many times that we are a leading state when it comes to providing comprehensive and compassionate care in innovative ways that bend the cost curve and improve outcomes. We can continue our successes, but only if adequate resources are provided.

Although we do not yet have specific state-level projections for the Senate’s discussion draft released on June 22, it is clear that such a plan will greatly reduce future support for our Medicaid program.

Jointly funded by our state and the federal government, Indiana’s Medicaid program provides coverage for one in five Hoosiers, including more than 600,000 children and pregnant women.

This coverage ensures that more young children get regular, preventative doctor visits and that pregnant mothers receive quality prenatal care, which significantly reduces the likelihood of infant mortality and costly premature deliveries. The program also covers more than 100,000 of our most vulnerable citizens, including the elderly, blind, disabled, and children in foster care.

If Indiana’s ability to provide coverage to these individuals is threatened, hospitals and other providers must brace for an increase in uncompensated care. But we must also keep in mind that reductions in Medicaid funding will ultimately impact not just patients, hospitals and those within health care — there would be substantial impacts to each and every Hoosier and all sectors of the economy.

Indiana currently spends about $2 billion in general funds annually for Medicaid, but this helps leverage another $8 billion in federal funding. These are real dollars that support above-average wages in the health care industry which are then spent in local businesses, supporting thousands of jobs statewide.

If the total amount of spending is reduced, state policymakers will face difficult choices. We are fortunate to live in a state with strong fiscal foundation, but if Indiana must shift resources away from other areas, this could jeopardize recent gains in road infrastructure investment, K-12 education programs and more.

In addition, the HIP 2.0 program is funded with Medicaid matching dollars and is vital to winning the battle against opioid abuse in communities across Indiana. We all have an interest in adequate funding for this program, and we hope that our U.S. senators and representatives will look carefully at the long-term impact on Medicaid under any legislation.

Brian Tabor is the president of the Indiana Hospital Association. Send comments to awoods@tribtown.com.