Exeter resident Suzanne Brooks said she will forgo her own medical needs to care for her young children, ages 1, 2 and 5, if she loses medical assistance as a result of the New Hampshire Legislature cutting Medicaid funds for the state's largest hospitals.
"I probably wouldn't go to the doctor if I didn't have Medicaid," she said.
Is this what the Republican majority had in mind when they ended the Disproportionate Share Hospital Program that reimbursed hospitals for their provision of Medicaid to uninsured patients? The state will continue providing this financial assistance to the state's smaller, critical-access hospitals, but those are in rural areas with smaller populations. Meanwhile, most of the state's largest hospitals, which care for the vast majority of New Hampshire residents, are now weighing a slew of cuts to deal with an unexpected loss of revenue.
And 10 of them are suing the state, seeking an injunction to stop the Medicaid cuts from being implemented. If they are successful, the state's budget will be immediately out of balance.
Exeter Hospital is considering terminating its contract with Medicaid, cutting staff and no longer funding several community-based programs like Lamprey Health Care in Newmarket. Dartmouth-Hitchcock Medical Center mentioned the possibility of ending its Dartmouth-Hitchcock Advanced Response Team helicopter rescue program, which assisted in a fatal accident on Interstate 95 last month. Several hospitals are considering cutting jobs and offering early retirement to some of the most experienced personnel.
This is not a job-creating measure that Republicans tout as being their goal in trimming state spending. If any of the Republican spending cuts could be labeled as penny wise and pound foolish, this is it.
Republican Speaker William O'Brien, Rep. Lynne Ober and Rep. Neal Kurk defended the Medicaid cuts in an op-ed in the Aug. 14 Seacoast Sunday, referring to short-term pain for long-term benefits. Was a single mom's loss of medical care the short-term pain they envisioned? The GOP trio defended the decision to cut the Medicaid funds by blaming the federal government's stimulus and federal health care reform, which they sarcastically referred to as "ObamaCare."
They offered little on how someone like Suzanne Brooks is supposed to live without Medicaid.
The three did reason that the state budget moves $157 million over two years into the Medicaid program from the uncompensated care fund to offset the loss of federal stimulus funds. They said, "We did this because it was more important for the state to keep its commitment to the poor and disabled that are covered under Medicaid than to continue to provide the state's largest hospitals with funding for their bad debt, unpaid care and other unreimbursed costs."
Bad debt or not, the hospitals' reaction to cut jobs and assistance for the most needy leaves those people twisting dangerously in the wind. But it's not only the most needy who may suffer. Someone who stops going to physician visits due to the cuts may turn to emergency room care. Overreliance on much more costly ER visits is likely to result in higher charges for other services and inevitable insurance premium increases.
Republicans made some questionable decisions this session, including lowering the cigarette tax, which may cost up to $30 million in state revenue over the next two years. But it is the poorly vetted decision to pull up to $250 million from the state's largest hospitals that stands out the most. The Legislature held scant hearings on the proposal, a process Republicans were critical of Democrats about last year, most notably over the "LLC tax."
It's unfortunate that the budget could be imbalanced by a lawsuit, but in this case, we hope the hospitals succeed in their suit and the GOP can do a better job when they return to Concord.
# As shared; Seacoastonline.com August 16, 2011
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