In 2022, a breath therapist checked patients in a hospital in Chicago. (Scott Olson | Getty Images)
The giant tax and expenditure calculation that President Donald Trump was signed in the law at the weekend The biggest expenses for health care In the history of the United States. In response, the states try to protect their hospitals from the impending loss of hundreds of millions of federal funds.
In Georgia, An significant state panel at the end of the last month It was about steps to send more state medicaid money to hospitals, in the hope of maximizing the federal matching dollars before the cuts become effective. Other states are considering novel subsidies that would transfer additional money to rural hospitals. Some state legislation will probably work together again to discuss how they can fill holes in their Medicaid budgets.
The tax and expenditure calculation Cut more than $ 1 trillion By Medicaid, the public health insurance program for people with low income, which is jointly financed by states and the federal government. As part of the measure, payments to hospitals or care facilities would likely Acceptance of at least 29 countriesAccording to an analysis by KFF, a non -profit health policy group.
In view of such budget deficits, the states may have to stop offering optional medical services such as vision and dentist to reduce the tariffs that they pay to the providers -which can reduce access for Medicaid participants -and to change the obligation to authorize so that fewer people qualify for cover.
State political decision -makers and health experts fear that the loss of financing will also endanger hospitals, especially in rural areas that will make uncompensate to shorten or complete services.
“Ultimately, when these hospitals close what happens, people now have to travel longer for care. They couldn’t even make it,” said Dr. Anahita Dua, a vascular surgeon in the Massachusetts General Hospital and in Southern New Hampshire Medical Center last week during a press conference organized by Defend America Action.
“Ultimately, this will not only affect the lives of people who do not receive care, but also the majority of hospitals who offer this care and the people who are employed by these locations,” she said.
At the beginning of this month, an analysis of the state health and value strategy program at Princeton University estimated that hospitals would lose 18% of their medicaid financing. Almost 665 billion US dollars over the next 10 years.
The Republicans have officially welcomed the Megabill – the title “The One Big Beautiful Bill Act – as one that reduces waste, fraud and abuse in federal programs, protect the US border and economic growth. The measure is add According to the Congress’s household office, at least 3 trillion dollars for public debt in the next decade and evaluated by some independent economists as a probably impact on growth. Dollars derived from Medicaid will go to the tax cuts prioritized by Trump as well as novel expenses for immigration control and defense projects.
Recaluate legislators
Experts in health policy assume that at least a few states will have to withdraw their legislation to the meeting to eliminate gaping household holes due to the Medicaid cuts.
States can expect to lose 3%-18% from your federal medicaid financing over 10 years according to the law of state health and value strategy program. Arizona, Kentucky and Virginia would see the greatest stocks of their Medicaid dollars evaporate.
Colorado democratic governor Jared Polis has said He will probably tell the legislator.
“With almost quite certainty if some of these major cuts go through Medicaid … we would probably have to repeat again, depending on what the congress is doing,” said Polis at one press conference in May.
The political decision -makers in some states have tried to be ahead of the expected minor works.
At the end of June, the Georgia Department of Community Health Health An emergency meeting. In a unanimous vote, the board of directors approved several measures to raise the reimbursement rate of the state of Medicaid.
For example, the state of Medicaid payments to hospitals would like to significantly raise that achieve certain goals, e.g. B. the training of Georgia doctors and the care of babies. The move would deduct an additional 2.1 billion US dollars a year.
“We do our best to react to the Medicaid talks in Washington,” Commissioner Russel Carlson told the department at the meeting. “Not overreacting in this 24/7 news cycle, but the best information that we can read the political environment as well as possible and act responsibly.”
Have other states Submitted similar inquiries with the Federal Centers for Medicare & Medicaid services and approval in the past few months.
“Of all the Medicaid discussions in Washington,” said Carlson, “is one of the political decisions that may, depending on, depending on the end, the Georgians most influenced the discussion about the payment programs.”
Grants for hospitals
Some of the largest federal savings in the novel law come from the restriction of using a financing instrument by the states. Known as provider taxThis enables you to withdraw more federal dollars. States employ the additional money to raise reimbursement rates for hospitals and expand the cover.
Some Republicans of the Congress have the maneuver as “convicted”Money laundering program“But the reduction in provider taxes will probably probably Beat large holes in the state medicaid budget.
In the meantime, some state legislates are examining alternative options for supporting financing for hospitals. A cross -party bill that is still being examined in Pennsylvania Create a program for rural health states To pay off the student loans for rural doctors, nurses and dentists. Indiana And Oklahola In this session, invoices were also viewed to create subsidies for rural hospitals.
In April, the Texas Republican Governor Greg Abbott announced that the state would publish more than 6 million US dollars in grants to support rural hospitals.
The Stateline reporter Anna Claire full of can be achieved aollers@stateline.org.
