It was never meant to happen this way. States like Georgia, which has the nation’s sixth-highest uninsured rate, were supposed to be the biggest beneficiaries of the new Medicaid dollars. But in 2012, the Supreme Court unexpectedly ruled that the federal government couldn’t force states to accept the expansion. Along with 22 other states with Republican governors or statehouses, Georgia Gov. Nathan Deal has refused to go along with the Medicaid expansion, saying the cost to the state would be untenable. Democrats counter that it’s a cruel political stunt, since the cost of new coverage is overwhelmingly paid for by the federal government. So safety-net hospitals like Grady are now caught in the middle: they aren’t getting new Medicaid funding, yet they’ll see a cumulative $18 billion reduction in federal payments by 2020. Grady alone expects to lose $45 million in annual federal subsidies by 2018 because of Obamacare. At the same time, it’s losing the opportunity to gain $25 million a year in new revenue because of Georgia’s decision to opt out of the Medicaid expansion, which the hospital says would cover 30,000 of its patients. Grady is also facing immediate reductions from the county government, which helps foot the bill for its uncompensated care. Fulton County has proposed to reduce its funding to Grady from $50 to $25 million, and it’s expected to come to a final decision this Wednesday. As the fiscal pressures mount, mental health services for low-income residents are especially vulnerable to cutbacks. On an annual basis, “the mental health department leaves us $8 million in the hole,” says John Haupert, Grady Hospital’s CEO. “As a business decision, that lands it on the list.”..msnbc ***
Posted on: Wed, 22 Jan 2014 03:40:09 +0000
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