Health providers to D.C.: Do better

March 27--It's a major understatement to say Americans are divided over the issue of health care. As was made clear last week, not only is Congress divided over health care (we've known that since well before the Affordable Care act -- Obamacare -- passed without a single Republican vote), but Republicans are themselves divided over health care. The American Health Care Act, the Trump administration's proposed ACA replacement, was pulled at the last minute due to a split between the GOP's right wing, whose members didn't think the dismantling of ACA went far enough, and moderates concerned about Congressional Budget Office projections that AHCA would cut Medicaid expenditures by $880 billion over the next decade and increase the rolls of the uninsured by 24 million Americans.

Among Georgians, perspectives are as divided as anywhere else. For instance, U.S. Rep. Buddy Carter, R-Ga., said in a statement he was a "strong supporter of the American Health Care Act because Americans cannot continue living with the Obamacare train wreck ... Thanks to this failed experiment, premiums and health care costs have skyrocketed, choice has been eliminated, and the dire situation is only getting worse."

According to Grady Health System CEO John Haupert, on the other hand, health professionals in Georgia -- specifically hospital, physician and nurse organizations, he told Georgia Health News -- saw more potential wreckage in AHCA, and were "united against the bill." The greatest danger, Haupert said, was to "safety net" facilities like Grady in Atlanta, other urban hospitals and rural hospitals, all of which treat large numbers of poor and uninsured patients and thus depend most heavily on Medicaid.

This opposition was not a hold-the-line defense of Obamacare ("We still have these issues within the ACA that are a little messy," Haubert said), so much as resistance to a "replacement" plan its critics argue would replace far too little.

Grady Health System officials estimated that the AHCA plan would have cost Grady alone some $65 million a year. Haubert, in letters to members of Congress, said the venerable Atlanta public hospital would have to eliminate at least 10 percent of its operating budget and "reduce critical services for Georgians," including mental health, primary and specialty care services. (Medicaid accounts for more than a third of Grady's patient service revenue.)

After the Friday reprieve, the Georgia Hospital Association issued a statement calling on the state's congressional delegation to "reject measures that would jeopardize access to care for hundreds of thousands of Georgians, increase our uninsured population, weaken the state's Medicaid program and reduce hospitals' ability to meet the needs of their patients 24 hours a day, seven days a week.''

Haupert got more pointedly into the politics of it, calling proposed ACHA cuts part of the shifting of federal spending for the sake of tax overhaul: "The tax reform package [would be] almost entirely funded on the backs of Medicaid."

Whatever the case, it's now a moot debate. But surely not for long.

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