If Tennessee and Virginia leaders don't expand Medicaid in their states as part of the Affordable Care Act, the region's two leading health care systems say the impact would be devastating to patients and employees.
Mountain States Health Alliance and Wellmont Health System made a rare appearance together today to get that message out.
Under the Affordable Care Act, both hospital systems previously agreed to cuts with the understanding they'd be able to recoup their losses once the federal government sponsored Medicaid expansion went forward. However, there is no guarantee that expansion, along with the hundreds of millions of dollars in federal reimbursements that come with it, will occur in Tennessee or Virginia.
Mountain States Health Alliance and Wellmont Health System are lobbying their legislators to make sure it happens. Otherwise, they say they'll be forced to make some tough decisions. So far, they say legislators have been receptive and clearly don't have their minds made up.
"Certainly if the expansion doesn't happen, we are going to have to take into account what we're going to do to offset that, which could involve some reduction in services," Mountain States Health Alliance Chief Financial Officer Marvin Eichorn said. "Obviously, we're still hoping and praying that legislators in both of the states go forward and do this, so we don't have to face some pretty significant moves on our part."
"If the Medicaid expansion population does not come about and we have to sustain all these Medicare reimbursement cuts, that could very much change the landscape of the services that we're able to provide in this community," Wellmont Health System Chief Financial Officer Alice Pope said. "Obviously, we have to make that up somewhere, so that will mean either cuts in services, which then results to a lower employee base, so it has an impact that's far reaching."
The Tennessee Hospital Association announced today failure to expand Medicaid would have a more than $13 billion "recessionary impact" on Tennessee's communities and could result in the loss off more than 90,000 jobs.
Tennessee Governor Bill Haslam promised in his State of the State address, he planned to clearly understand the impact before making any kind of decision about Medicaid expansion.
"Expanding Medicaid is not reflected in this year's budget," the governor said that night. "I am hesitant to commit additional dollars to Medicaid when it's already eating up so much of our budget, and we have to remember what the state went through seven years ago when it made the difficult decision to cut a lot of people from the TennCare rolls. We have to be very deliberate about making a decision to add that many and more back to the rolls, but I also understand that the decision isn't just as easy as standing here today and saying, 'We're not going to expand Medicaid.' There are hospitals across this state, many of them in rural communities, that are going to struggle if not close under the health care law without expansion, and that's not something to take lightly. Most of us in this room don't like the Affordable Care Act, but the decision to expand Medicaid isn't as basic as saying, 'No ObamaCare, No expansion.' I plan to gather all of the information possible to understand the impact on our budget, the impact on community hospitals, the impact on health care in Tennessee, and the impact on our citizens. This decision is too important not to do that."
A Tennessee senator has proposed banning the state from participating in the Medicaid expansion. Just today, Lt. Governor Ron Ramsey said that fellow Republican has agreed to delay debate about that bill to give the governor more time to look into expansion.