Paul Ryan, U.S. Speaker of the House of Representatives, said in a recent interview that any repeal of the Affordable Care Act (Obamacare) would be done so that “no one is worse off.” To keep that promise, Congress should work to reverse hospital payment cuts that were reduced as part of the Affordable Care Act.
The initial Obamacare cuts to hospital payments came through Medicare and Medicaid, the federal programs that fund health care services for the poor and the elderly. When hospitals took patients who were insured through Medicare (the elderly) and Medicaid (those with low incomes), the federal government reimbursed hospitals for the care they provided. To raise the money needed to fund Obamacare, the federal government cut hospital payments for those critical programs.
That’s why millions of us who live in rural Iowa are relying on Congress to restore the hospital payment cuts that were made to help fund the passage of Obamacare. Without restoring these cuts, many of our local hospitals will be starved of hundreds of billions of dollars and will have no choice but to shut down critical services, putting the health of untold numbers of Iowa’s most vulnerable citizens at risk.
Unfortunately, much of rural Iowa is considered medically underserved. That’s why this topic is important to our state and to my organization, the Iowa State Grange. Rural Americans are statistically older and more likely to be a part of the millions of Medicare beneficiaries, making Medicare functionality and preservation essential for rural residents and Iowa State Grange members. Thus, we are relying on our elected Congressional representatives to act thoughtfully, paying critical attention to the elderly and sick in these underserved regions.
Along with the repeal and replacement of Obamacare, we need to be sure that Iowa’s most rural hospitals are getting the funds they need to care for our nation’s most vulnerable citizens, as we believe that access to affordable healthcare should not depend upon geographic location.
A study by Virginia-based health insurance consulting firm Dobson/DaVanzo has estimated that total hospital financial losses would exceed $400 billion by 2026 if the Medicare and Medicaid payment cuts are not restored. Iowa hospitals alone would experience a $752 million reduction in Medicaid Disproportionate Hospital Payments (DSH) and the Medicare Market Basket and productivity in the state would be reduced by $2.69 billion from such a repeal, without the restoration of the essential funds.
Our community’s hospitals receive roughly half of their funding through Medicare and Medicaid. Losses of that magnitude would result in deep cuts to critical services for those in our state, including Iowa State Grange members. Some of our local rural hospitals could even be forced to close, to lay off doctors and nurses, and reduce or eliminate some essential services.
Hospitals are often among the largest employers in a community and are the employers of many of our Iowa State Grange members. In 2015, Iowa reported over 68,000 full-time and part-time hospital jobs. Should Congress fail to act, hardworking Iowans will be forced out of their jobs. These cuts would create an economic ripple effect that would spread like a shock wave from community hospitals all across the country. Already, dozens of community hospitals have been forced to close due to these Medicare and Medicaid cuts. Iowa State Grange members do not need to face the harsh reality of an inactive Congress.
However one feels about Obamacare, no act of the United States government should turn our rural hospitals and our Iowa State Grange members into its victims. Failing to restore these hospital payments would break Speaker Ryan’s promise that “no one is worse off.” The Iowa State Grange is counting on their thoughtfulness and leadership of those elected to serve on our behalf.
Dwight Baldwin, of Kellogg, is the President of the Iowa State Grange, an organization that strives to provide opportunities for individuals and families to develop to their highest potential in order to build stronger communities and states, as well as a stronger nation.