Healthcare Bill Raises Local Concerns

DAYTON--On June 22, Chief Financial Officer Cheryl Skiffington presented the Columbia County Health System Board of Commissioners with the American Hospital Association and the Washington State Hospital Association positions regarding the U.S. Senate’s Better Care Reconciliation Act of 2017, which is the Republican proposal to repeal and replace the Affordable Care Act. The CCHS pays dues to both hospital associations, Skiffington said.

“This is not partisan,” she clarified.

Skiffington read a statement to the commissioners, from the AMHA CEO Rick Pollack:

“From the onset of this debate, America’s hospitals and health systems have been guided by a set of key principals that would protect coverage for Americans. Unfortunately, the draft bill under discussion in the Senate moves in the opposite direction, particularly for our most vulnerable patients.

“The Senate proposal would likely trigger deep cuts to the Medicaid program that covers millions of Americans with chronic conditions such as cancer, along with the elderly and individuals with disabilities who need long-term services and support. Medicaid cuts of this magnitude are unsustainable and will increase costs to individuals with private insurance. We urge the Senate to go back to the drawing board and develop legislation that continues to provide coverage to all Americans who currently have it,” Pollack said.

Skiffington then read a statement from the Washington State Hospital Association.

“Everyone talks about a better health care system, but the Senate’s bill, like the House’s, purposely limits coverage for hundreds of thousands of people in Washington State.

“Denying people health coverage only makes people sicker and drives up the cost of care for everyone, including employers and working families. This bill is the wrong direction for this state. Under the Senate bill, far fewer vulnerable Washingtonians will have access to health coverage. While the Senate bill withdraws federal support to the Medicaid program more gradually than the House bill, the same basic structure, with phased-out funding and draconian cuts, will have the same result for hundreds of thousands, without coverage, and will create a massive cost shift to the state budget.”

Skiffington said prior to the ACA, a substantial number of people with chronic illness were seen frequently in both CCHS clinics, with no ability to pay for the care they received.

After the ACA went into effect in 2010, the CCHS received payments for fully 1/3 of those patients, Skiffington said.

“The ACA has helped this organization, and as I have been in other groups, with other CFOs of other hospitals, finally we had room to breathe after long periods of time of operating on the edge, and we have definitely seen improvement,” said Skiffington.

The ACA expanded coverage for 98 patients in the community, said CEO Shane McGuire.

McGuire said Medicaid is a secondary payer for a lot of inpatient swing bed patients. He also said the state is forcing a change in medical necessity criteria for long-term care. Two years ago, 90% of patients in the Booker Rest Home were on Medicaid, and that has been cut in half, he said.

Skiffington said Medicaid reimbursements might be delayed if the state legislature fails to pass a budget for 2018.

“On July 1, everything but essential services will be shut down, which means we won’t be getting Medicaid payments until they ratify the budget.” Also, people won’t be able to sign up for services during that time, she said.